NPIMap

Organization Active NPI

Creating Connections PC

  • Psychologist
  • Chicago, IL
National Provider Identifier
1033530449
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071005780 Issued in IL
Legal business name
CREATING CONNECTIONS PC
Practice address
1300 W Belmont Ave Ste 407
Chicago, IL 60657-3242
Phone
(773) 297-2696
NPI assigned
Jan 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Authorized official

Name
Dr. Manisha Dayal, PSY.D.
Title
Owner/Clinical Psychologist
Phone
(773) 297-2696

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 071005780 IL Primary

Addresses

Primary practice location

1300 W Belmont Ave Ste 407
Chicago, IL 60657-3242

Mailing address

1300 W Belmont Ave Ste 407
Chicago, IL 60657-3242
Phone (773) 297-2696

Other identifiers 1

IdentifierTypeStateIssuer
01622706OtherILBLUE CROSS BLUE SHIELD PPO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1033530449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE STE 407",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573242",
            "telephone_number": "773-297-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE STE 407",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573242",
            "telephone_number": "773-297-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATING CONNECTIONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "DAYAL",
        "authorized_official_first_name": "MANISHA",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "773-297-2696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071005780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PPO",
            "identifier": "01622706",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.