Rebecca Wynne Denosaquo, PSY.D.
Individual provider Active NPI Clinical Psychologist · Winnetka, IL
NPI 1003075979 · NPPES record last updated Aug 17, 2015
Key facts
- NPI
- 1003075979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 071007453 (IL)
- Practice address
- 545 Lincoln Ave
Suite 15
Winnetka, IL 60093-2349 - Phone
- (847) 331-9156
- NPI assigned
- Jun 5, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Dec 12, 2019 through Dec 12, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071007453 | IL | Yes |
Addresses
Primary practice location
545 Lincoln Ave
Suite 15
Winnetka, IL 60093-2349
Mailing address
902 N Moki LN
Mount Prospect, IL 60056-1927
Phone (847) 331-9156
Other providers in Winnetka, IL
- Dani Walsh Therapy, PLLC
- Robert E Daniels
- David a Sisk PHD Inc
- David R Donnersberger MD SC
- Dedication Health LLC
- Loren Hart Deutsch
- Direct RX Exchange, LLC
- David R. Donnersberger
- Maria Detolve Donoghue
- Doyle Opticians LTD.
All providers in Winnetka, IL · Clinical Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.