Nicholas Fredrick, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071010033 Issued in IL

Practice address

1595 Weld Rd Ste 5
Elgin, IL 60123-5896

Phone

(262) 308-6257

NPI assigned

Sep 15, 2010

Sex

Male

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

Electronic endpoints 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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Adlerian Wellness Center, LTD

  • Psychologist
  • Elgin, IL
  • NPI 1639743362
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1013225879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5558 W EDMUNDS ST APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606304698",
            "telephone_number": "262-308-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 WELD RD STE 5",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235896",
            "telephone_number": "262-308-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICK",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-15",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGIST LICENSE",
            "identifier": "071010033",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "nfredrick85@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "address_1": "5558 W Edmunds St Apt 1",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606304698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teresa Frankel, RD, LDN
• Mary Lynette Franklin
• Anne Franks
• Carl Frazier
• Jolene Frazier, LCPC LMFT
• Freedom Dental LTD
• Michael William Fremgen
• French Medical Group, LTD
• Fresenius Medical Care Elgin, LLC
• Fresenius Medical Care of Illinois, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.