Active NPI
Michael R Binder, M.D.
- Psychologist
- Highland Park, IL
National Provider Identifier
1083632590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 30357-020
- Practice address
- 767 Park Ave W
Suite 210
Highland Park, IL 60035-2400 - Phone
- (847) 681-8311
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 30357-020 | WI | Primary |
Addresses
Primary practice location
767 Park Ave W
Suite 210
Highland Park, IL 60035-2400
Mailing address
767 Park Ave West
Suite 210
Highland Park, IL 60035-2400
Phone (847) 681-8311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31798800 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 15, 2016 through Feb 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30357-020 | WI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael R Binder | Psychologist | Past | Accepting new patients |
| Inner Awakenings Diagnostic and Counseling Clinic | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychologist
- Highland Park, IL
- NPI 1578693180
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Pewaukee, WI
- NPI 1679788103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1083632590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "767 PARK AVE WEST",
"address_2": "SUITE 210",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600352400",
"telephone_number": "847-681-8311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "767 PARK AVE W",
"address_2": "SUITE 210",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600352400",
"telephone_number": "847-681-8311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BINDER",
"first_name": "MICHAEL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "30357-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31798800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.