Dr Margot Gay Mahan & Assoc PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006277 Issued in IL

Legal business name

DR MARGOT GAY MAHAN & ASSOC PC

Practice address

1555 Naperville Wheaton Rd
Suite 115
Naperville, IL 60563-1557

Phone

(312) 719-1360

Fax

(773) 751-2250

NPI assigned

Aug 11, 2010

Organization subpart

No

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

Authorized official

Name

Margot Gay Mahan, PSYDNPI 1669568077

Title

President

Phone

(312) 719-1360

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Margot Gay Mahan, PSY.D.

  • Clinical Psychologist
  • Naperville, IL
  • NPI 1669568077

  IL

  Medicare reassignment Authorized official
• Theresa A. Bussert, L.C.S.W.

  • Clinical Social Worker
  • Wheaton, IL
  • NPI 1376503177
  NPD (past)

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1083929327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NAPERVILLE WHEATON RD",
            "address_2": "SUITE 115",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631557",
            "telephone_number": "312-719-1360",
            "fax_number": "773-751-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 NAPERVILLE WHEATON RD",
            "address_2": "SUITE 115",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631557",
            "telephone_number": "312-719-1360",
            "fax_number": "773-751-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MARGOT GAY MAHAN & ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "MAHAN",
        "authorized_official_first_name": "MARGOT",
        "authorized_official_middle_name": "GAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-719-1360",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "4098289017",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Naperville, IL
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.