Individual provider Active NPI

Patricia A Pimental, PSYD

  • Clinical Neuropsychologist
  • Elmhurst, IL
National Provider Identifier
1073673406
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
071004014 Issued in IL
Practice address
180 W Park Ave Ste 260
Elmhurst, IL 60126-3372
Phone
(708) 997-4216
Fax
(844) 273-7876
NPI assigned
Dec 8, 2006
Last updated
May 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X
Clinical Neuropsychologist 103G00000X 071004014 IL Primary

Addresses

Primary practice location

180 W Park Ave Ste 260
Elmhurst, IL 60126-3372

Mailing address

180 W Park Ave Ste 260
Elmhurst, IL 60126-3372
Phone (708) 643-4059

Other identifiers 1

IdentifierTypeStateIssuer
1673508OtherILBCBS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120314000668 IL Practitioner - Clinical Psychologist 4284893074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

180 W Park Ave
Suite 260
Elmhurst, IL 60126-3372
Phone (708) 643-4059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071004014ILMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurobehavioral Medicine Consultants LTD Clinical Neuropsychologist CurrentSince Aug 1, 1997 Accepting new patients

Locations

180 W Park Ave
Ste 260
Elmhurst, IL 60126
Phone (708) 569-1432

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1073673406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 W PARK AVE STE 260",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263372",
            "telephone_number": "708-643-4059",
            "fax_number": "844-273-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W PARK AVE STE 260",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263372",
            "telephone_number": "708-997-4216",
            "fax_number": "844-273-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMENTAL",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071004014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1673508",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.