Chicago DBT, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009608 Issued in IL

Legal business name

CHICAGO DBT, LLC

Practice address

3166 N Lincoln Ave Ste 214a
Chicago, IL 60657-3119

Phone

(503) 908-4691

Fax

(503) 200-1146

NPI assigned

Feb 16, 2018

Last updated

Feb 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas John Sotor, PSYD

Title

Owner

Phone

(503) 908-4691

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Nick J Sotor, PSYD

  • Clinical Psychologist
  • Deerfield, IL
  • NPI 1134465644
  NPD (past)

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1033619911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3166 N LINCOLN AVE STE 214A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573119",
            "telephone_number": "503-908-4691",
            "fax_number": "503-200-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3166 N LINCOLN AVE STE 214A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573119",
            "telephone_number": "503-908-4691",
            "fax_number": "503-200-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO DBT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-16",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "SOTOR",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-908-4691",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.