Individual provider Active NPI

Karen M. Meissler, PSY.D.

  • Clinical Psychologist
  • Geneva, IL
National Provider Identifier
1063579118
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071006783 Issued in IL
Practice address
115 Campbell St Ste 106-107
Geneva, IL 60134-2784
Phone
(630) 393-0672
Fax
(630) 393-0672
NPI assigned
Jan 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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 071006783 IL Primary

Addresses

Primary practice location

115 Campbell St Ste 106-107
Geneva, IL 60134-2784

Mailing address

115 Campbell St Ste 106-107
Geneva, IL 60134-2784
Phone (630) 393-0672

Other identifiers 1

IdentifierTypeStateIssuer
0002232846OtherILBCBS PROVIDER #

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
071006783ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1063579118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CAMPBELL ST STE 106-107",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342784",
            "telephone_number": "630-393-0672",
            "fax_number": "630-393-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CAMPBELL ST STE 106-107",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342784",
            "telephone_number": "630-393-0672",
            "fax_number": "630-393-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEISSLER",
        "first_name": "KAREN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "0002232846",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.