Susan Lynn Pelton, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-005401 Issued in IL

Practice address

30 N Michigan Ave
Suite 1703
Chicago, IL 60602-3402

Phone

(312) 909-9699

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Life Care Wellness, Inc.Group PAC ID 2860791449, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Life Care Wellness, Inc.

  • Professional Counselor
  • Glen Ellyn, IL
  • NPI 1952767733
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475971200000",
    "number": "1003947847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 S MICHIGAN AVE",
            "address_2": "SUITE 1032",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606044434",
            "telephone_number": "312-909-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1703",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-909-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTON",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2016-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "0001635663",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elvira Pellitteri, MSW, LCSW
• Amanda Pelly, MD
• Ryan Michael Pelo, DPT
• Murray Pelta, M.D.
• Kathryn Lucille Pelton
• Nancy V Peltzman, LCSW
• Philip M Pelusa, DDS
• Pelvic Floor Rehab LLC
• Harold Pelzer, MD
• Kristen Cawley Pelzer

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.