Individual provider Active NPI

Deborah G Johnson Heim, PSY D

  • Clinical Psychologist
  • Naperville, IL
National Provider Identifier
1083793632
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071005244 Issued in IL
Practice address
1701 Quincy Ave
Ste 31
Naperville, IL 60564
Phone
(630) 851-3370
Fax
(630) 428-1167
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 071005244 IL Primary

Addresses

Primary practice location

1701 Quincy Ave
Ste 31
Naperville, IL 60564

Mailing address

1701 Quincy Ave
Ste 31
Naperville, IL 60564
Phone (630) 851-3370

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
071005244ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Community Counseling Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083793632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 QUINCY AVE",
            "address_2": "STE 31",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60564",
            "telephone_number": "630-851-3370",
            "fax_number": "630-428-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 QUINCY AVE",
            "address_2": "STE 31",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60564",
            "telephone_number": "630-851-3370",
            "fax_number": "630-428-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON HEIM",
        "first_name": "DEBORAH",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.