Judith A Holmes, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071004106 Issued in IL

Practice address

1440 Renaissance Dr Ste 220
Park Ridge, IL 60068-1452

Phone

(847) 296-3442

Fax

(847) 296-3543

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Cognitive Care Counseling, PLLC

  • Clinical Social Worker
  • Huntley, IL
  • NPI 1013532191
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1013047018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR STE 220",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681452",
            "telephone_number": "847-296-3442",
            "fax_number": "847-296-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR STE 220",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681452",
            "telephone_number": "847-296-3442",
            "fax_number": "847-296-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "JUDITH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071004106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071004106",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Hogaboom
• Daniel Edward Hogan, D.M.D.
• Holistic Warrior Whgy6
• Grace Hollander, RBT
• Delicia Holmes
• Thomas E Holmes, LCSW
• Thomas G Holmes, M.D.
• Calla M Holmgren, MD
• Katelyn Holsclaw, LCSW
• Sydney Holt

• Clinical Neuropsychologist in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.