Individual provider Active NPI

Quynh Chau, M.A.

  • Psychologist
  • Wheaton, IL
National Provider Identifier
1053787176
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
111 N County Farm Rd
Wheaton, IL 60187-3977
Phone
(630) 682-7400
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

111 N County Farm Rd
Wheaton, IL 60187-3977

Mailing address

111 N County Farm Rd
Wheaton, IL 60187-3977
Phone (630) 682-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20181001000184 IN Practitioner - Clinical Psychologist 3173874260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Porter-Starke Services IncGroup PAC ID 1951293554, 44 clinicians

Practice addresses (Care Compare)

601 Wall St
Valparaiso, IN 46383-2512
Phone (574) 772-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Porter-Starke Services Inc. CurrentSince Aug 20, 2018 Accepting new patients
Porter-Starke Services Inc. Current Accepting new patients
Porter-Starke Services Inc. CurrentSince Aug 20, 2018 Accepting new patients

Locations

601 Wall St
Valparaiso, IN 46383
Phone (219) 806-3011

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1053787176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N COUNTY FARM RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873977",
            "telephone_number": "630-682-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N COUNTY FARM RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873977",
            "telephone_number": "630-682-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAU",
        "first_name": "QUYNH",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.