Thad S Rydberg, MA, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180005506 Issued in IL

Practice address

3139 N Lincoln Ave Ste 203
Chicago, IL 60657-3122

Phone

(773) 726-3295

NPI assigned

Jan 9, 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: Yes
• 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

Credentials

Master of Arts

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.

• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  Medicare reassignment NPD
• Rush University Medical Center

  • Internal Medicine Physician
  • Oak Brook, IL
  • NPI 1801375696
  NPD

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

{
    "created_epoch": "1294531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294531200000",
    "number": "1063716892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3139 N LINCOLN AVE STE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573122",
            "telephone_number": "773-726-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3139 N LINCOLN AVE STE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573122",
            "telephone_number": "773-726-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDBERG",
        "first_name": "THAD",
        "middle_name": "S",
        "credential": "MA, LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-09",
        "last_updated": "2011-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180005506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Ellen Rychener
• Lauren Christine Ryczek, CRNA
• Stephanie Ryczewicz
• Carolyn Alys Rydberg, APRN
• Leslie K Rydberg, MD
• Katherine Marie Rye, D.O.
• Ryerson Podiatry Center
• Alissa Ann Rygel, LCPC
• Lauren Beth Ryland, DPT
• Sheri Rylko, DNP, CRNA

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2011; 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.