NPIMap

Organization Active NPI

Heritage Professional Associates LTD

  • Psychologist
  • Hinsdale, IL
National Provider Identifier
1033244173
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
060005612 Issued in IL
Legal business name
HERITAGE PROFESSIONAL ASSOCIATES LTD
Practice address
120 E Ogden Ave 220
Hinsdale, IL 60521
Phone
(630) 325-5300
Fax
(630) 325-5309
NPI assigned
Feb 22, 2007
Last updated
Aug 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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

Authorized official

Name
Mr. Keith A Baird, PHD ABPPNPI 1609830835
Title
Licensed Clinical Psychologist Pres
Phone
(630) 325-5300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 060005612 IL Primary

Addresses

Primary practice location

120 E Ogden Ave 220
Hinsdale, IL 60521

Mailing address

120 E Ogden Ave 220
Hinsdale, IL 60521
Phone (630) 325-5300

Other identifiers 1

IdentifierTypeStateIssuer
02215636OtherILBCBS OF IL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324001488 IL Part B Supplier - Clinic/Group Practice 6002707262 Receives reassigned benefits from 21 practitioners
Practice locations: Chicago, IL; Hinsdale, IL; Wheaton, IL

National Provider Directory

National Provider Directory
Tax ID family
Heritage Professional Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

112 E Chestnut St
Chicago, IL 60611
Phone (312) 787-2729

126 E Chestnut St
Fl 3
Chicago, IL 60611
Phone (312) 787-8425

120 E Ogden Ave
Ste 2
Hinsdale, IL 60521
Phone (630) 325-5300

1737 S Naperville Rd
Ste 206
Wheaton, IL 60189
Phone (630) 325-5300

Practitioners & affiliated clinicians

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1033244173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E OGDEN AVE 220",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "60521",
            "telephone_number": "630-325-5300",
            "fax_number": "630-325-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E OGDEN AVE 220",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "60521",
            "telephone_number": "630-325-5300",
            "fax_number": "630-325-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE PROFESSIONAL ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "BAIRD",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST PRES",
        "authorized_official_telephone_number": "630-325-5300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD ABPP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "060005612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "02215636",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.