Lynn Ellen Nelson

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071004944 Issued in IL

Practice address

3330 Old Glenview Rd
Suite 15
Wilmette, IL 60091-2963

Phone

(847) 204-1557

NPI assigned

Dec 7, 2009

Last updated

Dec 7, 2009By the provider in NPPES

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

Other identifiers 1

Other names 1

• Lynn Ellen Fitzgerald Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lynn E. Nelson, Psy.D., P.C.

  • Clinical Psychologist
  • Wilmette, IL
  • NPI 1093795106
  Authorized official Same address or phone

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1033447834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 OLD GLENVIEW RD",
            "address_2": "SUITE 15",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912963",
            "telephone_number": "847-204-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 OLD GLENVIEW RD",
            "address_2": "SUITE 15",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912963",
            "telephone_number": "847-204-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LYNN",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-07",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071004944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1093795106",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "FITZGERALD",
            "middle_name": "ELLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keaton Clauss Muzika, PH.D
• Sally Jo Nador, PSYD
• Nancy S Molitor PHD PC
• NDP Dental Solutions PLLC
• E. Holly Nelson-Johnson, MSN, APN, FNP-BC
• Peter H. Neuhaus, DDS
• Ewa Nevler, LCSW
• New Moon Wellness, PLLC
• New Precise Vision Optical Inc. (precise vision optical)
• New Vision Optical

• Clinical Psychologist in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.