Northwest ADHD Center Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071005462 Issued in IL

Legal business name

NORTHWEST ADHD CENTER INC.

Practice address

121 S Wilke Rd
Suite 403
Arlington Heights, IL 60005-1533

Phone

(847) 577-7705

Fax

(847) 577-7712

NPI assigned

Feb 23, 2015

Organization subpart

No

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

Authorized official

Name

Carla Rocha

Title

Office Manager

Phone

(847) 577-7705

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1013309475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S WILKE RD",
            "address_2": "SUITE 403",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051533",
            "telephone_number": "847-577-7705",
            "fax_number": "847-577-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S WILKE RD",
            "address_2": "SUITE 403",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051533",
            "telephone_number": "847-577-7705",
            "fax_number": "847-577-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ADHD CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "ROCHA",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-577-7705"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009233",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005864",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.