Organization Active NPI

Wolff Clinical Group PLLC

  • Counseling Psychologist
  • Oak Park, IL
National Provider Identifier
1053059469
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
WOLFF CLINICAL GROUP PLLC
Practice address
137 N Oak Park Ave Ste 329
Oak Park, IL 60301-1375
Phone
(708) 381-0634
NPI assigned
May 25, 2022
Last updated
May 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
Dr. Kara Wolff, PHDNPI 1659651438
Title
Member
Phone
(773) 255-2799

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

137 N Oak Park Ave Ste 329
Oak Park, IL 60301-1375

Mailing address

4156 W 21St PL
Chicago, IL 60623-2831
Phone (773) 255-2799

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220801002781 IL Part B Supplier - Clinic/Group Practice 4082096441 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Park, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1053059469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4156 W 21ST PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232831",
            "telephone_number": "773-255-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE STE 329",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011375",
            "telephone_number": "708-381-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLFF CLINICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "773-255-2799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.