Individual provider Active NPI

Angela N Chastain, PSYD

  • Clinical Psychologist
  • Joliet, IL
National Provider Identifier
1053603266
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.008223 Issued in IL
Practice address
501 Ella Ave
Joliet, IL 60433-2799
Phone
(815) 727-8521
NPI assigned
May 5, 2011
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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 071.008223 IL Primary

Addresses

Primary practice location

501 Ella Ave
Joliet, IL 60433-2799

Mailing address

323 Quadrangle Dr
Bolingbrook, IL 60440-3409
Phone (815) 727-8521

Other practice location 1

2285 Sequoia Dr
Aurora, IL 60506-6209
Phone (630) 906-5120

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address achastain395679@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20160902000967 IL Practitioner - Clinical Psychologist 5294021093 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2285 Sequoia Dr
Aurora, IL 60506-6209
Phone (630) 859-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.008223ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Mar 22, 2024 Accepting new patients
Agor Behavioral Health Services, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 22, 2024 Accepting new patients

Locations

2285 Sequoia Dr
Aurora, IL 60506
Phone (630) 859-6700

2357 Sequoia Dr
Aurora, IL 60506
Phone (630) 859-6700

28594 Network Pl
Chicago, IL 60673

24402 W Lockport St
Ste 215
Plainfield, IL 60544
Phone (630) 621-5824

Organizations & group practices 3

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": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1053603266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 QUADRANGLE DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403409",
            "telephone_number": "815-727-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 ELLA AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604332799",
            "telephone_number": "815-727-8521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2285 Sequoia Dr",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605066209",
            "country_code": "US",
            "telephone_number": "630-906-5120",
            "fax_number": "630-906-5093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHASTAIN",
        "first_name": "ANGELA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "achastain395679@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2285 Sequoia Dr",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605066209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2285 Sequoia Dr",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605066209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.