Individual provider Active NPI

Laura Patton-Van Buskirk, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1063554186
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071005906 Issued in IL
Practice address
118 N Clinton St Ste 440
Chicago, IL 60661-2392
Phone
(312) 324-4332
Fax
(773) 907-9258
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 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 071005906 IL Primary

Addresses

Primary practice location

118 N Clinton St Ste 440
Chicago, IL 60661-2392

Mailing address

118 N Clinton St Ste 440
Chicago, IL 60661-2392
Phone (312) 324-4332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071005906ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Solutions Toward Optimal Health, PLLC Clinical Current Accepting new patients

Locations

118 N Clinton St
Ste 440
Chicago, IL 60661
Phone (312) 315-9995

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1063554186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N CLINTON ST STE 440",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606612392",
            "telephone_number": "312-324-4332",
            "fax_number": "773-907-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N CLINTON ST STE 440",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606612392",
            "telephone_number": "312-324-4332",
            "fax_number": "773-907-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON-VAN BUSKIRK",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.