Claire Pedersen, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.010379 Issued in IL

Practice address

7900 Cass Ave
Darien, IL 60561-5073

Phone

(630) 428-7890

NPI assigned

Oct 26, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lifestancehealth.clairepedersen@146897.advancedmd-direct.com

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1013517572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4865 N HERMITAGE AVE APT 3W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404138",
            "telephone_number": "708-606-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 CASS AVE",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605615073",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "CLAIRE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanjeni Ramesh Patel, D.C., MPH
• Taylor Patrick
• Ariel Patton, RBT
• Cathleen Martha Paullin
• Sylwia Jozefa Pawlik
• McKenna Peplow
• Emily Peralta, RBT
• Julissa Perez
• Nicasia Perez, MD
• Christina Anna Petrykiw, PHARM.D., CDE

• Clinical Psychologist in Darien, IL
• Providers in Darien, 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 26, 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.