Miki Koyama, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071008355 Issued in IL

Practice address

333 N Michigan Ave Ste 2400
Chicago, IL 60601-4040

Phone

(773) 609-0361

NPI assigned

Jan 29, 2024

Last updated

Jan 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1083476758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014040",
            "telephone_number": "773-609-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014040",
            "telephone_number": "773-609-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOYAMA",
        "first_name": "MIKI",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IL",
            "license": "071008355",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Kowalski, DNP, RN, AGACNP-BC
• Susanne Kowalski, D.C.
• Amber Sara Kowalsky, DNP
• Susanne Kowalsky
• Casey Kowitz, PA
• Yuka Koyama
• Jay Lawrence Koyner, M.D.
• Koz-Laz Incorporated (Archer Pharmacy)
• Barbara Kozak, PTA
• Justin Kozak

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.