Lifespan Neurodevelopmental Consultants

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071008839 Issued in IL

Legal business name

LIFESPAN NEURODEVELOPMENTAL CONSULTANTS

Practice address

33 N Dearborn St
Suite #1600
Chicago, IL 60602-3102

Phone

(847) 421-0122

Fax

(312) 781-6706

NPI assigned

Jun 20, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Paul Richmond, PSY.D.

Title

Licensed Clinical Psychologist

Phone

(847) 421-0122

Specialties & licenses 8

Addresses

Locations

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1003221755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 N DEARBORN ST",
            "address_2": "SUITE #1600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023102",
            "telephone_number": "847-421-0122",
            "fax_number": "312-781-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 N DEARBORN ST",
            "address_2": "SUITE #1600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023102",
            "telephone_number": "847-421-0122",
            "fax_number": "312-781-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN NEURODEVELOPMENTAL CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "RICHMOND",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "847-421-0122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071008839",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IL",
            "license": "071008839",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008839",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071008839",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": "IL",
            "license": "071008839",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health",
            "state": "IL",
            "license": "071008839",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "IL",
            "license": "071008839",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": "IL",
            "license": "071008839",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifesaver Intervention Center Inc
• Lifescan Chicago LLC
• Lifescan Labs of Illinois, LLC
• Lifescore Foundation
• Lifespan Behavioral Health P.C.
• Lifesport Physical Therapy PC
• Lifestart National Fitness
• Lifestyle Chiropractic PC
• Lifestyle Physical Therapy & Balance Center, PLLC
• Lifestyle Rejuvenation Medical Group PLLC

• Clinical Neuropsychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.