Individual provider Active NPI

Robert A Green, PHD

  • Clinical Psychologist
  • Schaumburg, IL
National Provider Identifier
1023110384
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
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

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
320078OtherILVALUE OPTIONS GRP NUMBER
1633897OtherILBCBS 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040228000188 IL Practitioner - Clinical Psychologist 4981591641 Reassigns benefits to 1 organization

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
Pra Behavioral LLCGroup PAC ID 3274427729, 24 clinicians

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

LicenseStateTypeSpecialty
071-005197ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pra Behavioral LLC Clinical CurrentSince Jan 1, 2004 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

Verify at the official NPI Registry.