Individual provider Active NPI

Wendy Heller, PH.D.

  • Clinical Neuropsychologist
  • Champaign, IL
National Provider Identifier
1003012790
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
71003954 Issued in IL
Practice address
505 E Green St
3Rd Floor, Psychological Services Center
Champaign, IL 61820-5723
Phone
(217) 333-0041
Fax
(217) 333-0064
NPI assigned
Jun 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 71003954 IL Primary

Addresses

Primary practice location

505 E Green St
3Rd Floor, Psychological Services Center
Champaign, IL 61820-5723

Mailing address

603 E Daniel St
Psychology Dept. Uiuc
Champaign, IL 61820-6232
Phone (217) 333-0041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
71003954ILMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Uiuc Psychological Services Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003012790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 E DANIEL ST",
            "address_2": "PSYCHOLOGY DEPT. UIUC",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618206232",
            "telephone_number": "217-333-0041",
            "fax_number": "217-244-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E GREEN ST",
            "address_2": "3RD FLOOR, PSYCHOLOGICAL SERVICES CENTER",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618205723",
            "telephone_number": "217-333-0041",
            "fax_number": "217-333-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "WENDY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "71003954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.