NPIMap

Organization Active NPI

Heart Light Psychological Services

  • Clinical Psychologist
  • Deerfield, IL
National Provider Identifier
1003932039
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
HEART LIGHT PSYCHOLOGICAL SERVICES
Practice address
747 Lake Cook Rd Ste 105W
Deerfield, IL 60015-4935
Phone
(847) 205-5698
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Authorized official

Name
Dr. Paul Edward Nevin, PSY.D.
Title
President
Phone
(847) 205-5698

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X IL Primary

Addresses

Primary practice location

747 Lake Cook Rd Ste 105W
Deerfield, IL 60015-4935

Mailing address

747 Lake Cook Rd Ste 105W
Deerfield, IL 60015-4935
Phone (847) 205-5698

National Provider Directory

National Provider Directory

Locations

747 Lake Cook Rd
Ste 105W
Deerfield, IL 60015
Phone (847) 205-5698

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1003932039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 LAKE COOK RD STE 105W",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154935",
            "telephone_number": "847-205-5698",
            "fax_number": "847-205-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 LAKE COOK RD STE 105W",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154935",
            "telephone_number": "847-205-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART LIGHT PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "NEVIN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-205-5698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.