Individual provider Active NPI

Jennifer A Roberts, PSY.D.

  • Clinical Psychologist
  • Hinsdale, IL
National Provider Identifier
1083873129
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007483 Issued in IL
Practice address
15 Spinning Wheel Road
Suite 426
Hinsdale, IL 60521-2914
Phone
(630) 323-3050
Fax
(630) 323-3058
NPI assigned
Jun 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 071007483 IL Primary

Addresses

Primary practice location

15 Spinning Wheel Road
Suite 426
Hinsdale, IL 60521-2914

Mailing address

15 Spinning Wheel Road
Suite 426
Hinsdale, IL 60521-2914
Phone (630) 323-3050

Other identifiers 1

IdentifierTypeStateIssuer
1633920OtherILBCBS

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
I20090605000220 IL Practitioner - Clinical Psychologist 9739239146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Lodestone Center for Behavioral Health PCGroup PAC ID 6709128317, 27 clinicians

Practice addresses (Care Compare)

15 Spinning Wheel Rd
Suite 426
Hinsdale, IL 60521-7671
Phone (847) 854-4058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071007483ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sonnenberg & Associates LLC Clinical PastSince Aug 1, 2007 Accepting new patients
Uptown Mental Health, Inc. PastSince Oct 22, 2017 Accepting new patients

Organizations & group practices 3

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": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1083873129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SPINNING WHEEL ROAD",
            "address_2": "SUITE 426",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212914",
            "telephone_number": "630-323-3050",
            "fax_number": "630-323-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SPINNING WHEEL ROAD",
            "address_2": "SUITE 426",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212914",
            "telephone_number": "630-323-3050",
            "fax_number": "630-323-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1633920",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.