Adam Lloyd Shafer, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.008760 Issued in IL

Practice address

820 W Jackson Blvd Ste 515
Chicago, IL 60607-3061

Phone

(708) 537-9951

NPI assigned

Aug 16, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Adam Shafer, P.C.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1659804003
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1053690461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N EUCLID AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021520",
            "telephone_number": "708-537-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W JACKSON BLVD STE 515",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073061",
            "telephone_number": "708-537-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "ADAM",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-16",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phyllis Joan Shadwick
• Michelle Lynn Martin Shaefer
• Barry Shaeffer, LCSW
• Houri H Shafaie, DDS
• Shafeeq H. Bader, D.D.S., S.C.
• Jonathan Meyer Shafer, DNP, APRN, PMHNP-BC
• Katherine Shafer, LCPC
• Natalie Ann Shafer, LPC
• Shaffer Counseling Solutions P.C.
• Amanda Shaffer, DMD

• 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 Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.