Active NPI
Robert A Green, PHD
- Clinical Psychologist
- Schaumburg, IL
National Provider Identifier
1023110384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Practice address
- 1701 E. Woodfield Road
Suite 1000
Schaumburg, IL 60173-5113 - Phone
- (847) 240-2211
- Fax
- (847) 240-2418
- NPI assigned
- Sep 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | IL | Primary |
Addresses
Primary practice location
1701 E. Woodfield Road
Suite 1000
Schaumburg, IL 60173-5113
Mailing address
1701 E. Woodfield Road
Suite 1000
Schaumburg, IL 60173-5113
Phone (847) 240-2211
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 320078 | Other | IL | VALUE OPTIONS GRP NUMBER |
| 1633897 | Other | IL | BCBS GROUP NUMBER |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1701 E Woodfield Rd
Suite 1000
Schaumburg, IL 60173-5113
Phone (847) 240-2211
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-005197 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pra Behavioral LLC | Clinical | Current | Accepting new patients |
Locations
1701 E Woodfield Rd
Ste 1000
Schaumburg, IL 60173
Phone (847) 240-2211
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1023110384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 E. WOODFIELD ROAD",
"address_2": "SUITE 1000",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601735113",
"telephone_number": "847-240-2211",
"fax_number": "847-240-2418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 E. WOODFIELD ROAD",
"address_2": "SUITE 1000",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601735113",
"telephone_number": "847-240-2211",
"fax_number": "847-240-2418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "ROBERT",
"middle_name": "A",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS GRP NUMBER",
"identifier": "320078",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP NUMBER",
"identifier": "1633897",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.