Individual provider Active NPI

Melanie A. Carli, PSY.D.

  • Clinical Psychologist
  • Arlington Heights, IL
National Provider Identifier
1053354688
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-006040 Issued in IL
Practice address
139 W. Rand Rd.
Arlington Heights, IL 60004-3985
Phone
(847) 259-8583
NPI assigned
Jun 13, 2006
Last updated
Nov 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-006040 IL Primary

Addresses

Primary practice location

139 W. Rand Rd.
Arlington Heights, IL 60004-3985

Mailing address

7835 Dana Way
Burr Ridge, IL 60527-5126
Phone (630) 662-0836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101206001228 IL Practitioner - Clinical Psychologist 5597952317 Reassigns benefits to 1 organization
Practice locations: Burr Ridge, IL; Elmhurst, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 E Lake St
Elmhurst, IL 60126-2013
Phone (630) 516-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-006040ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Institute of Chicago CurrentSince Jun 19, 2017 Accepting new patients

Locations

900 Skokie Blvd
Northbrook, IL 60062
Phone (847) 272-7426

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1053354688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7835 DANA WAY",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275126",
            "telephone_number": "630-662-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 W. RAND RD.",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600043985",
            "telephone_number": "847-259-8583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLI",
        "first_name": "MELANIE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-006040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.