Active NPI
Carolyn J Atkinson, PH.D.
- Clinical Psychologist
- Naperville, IL
National Provider Identifier
1093828824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 71-2038
- Practice address
- 43 E Jefferson Ave Ste 205
Naperville, IL 60540-8411 - Phone
- (630) 355-7008
- NPI assigned
- Aug 16, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 71-2038 | IL | Primary |
Addresses
Primary practice location
43 E Jefferson Ave Ste 205
Naperville, IL 60540-8411
Mailing address
326 Delta Rd
Highland Park, IL 60035-5204
Phone (847) 433-7367
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71-2038 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Susan B Andrews & Associates | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Naperville, IL
- NPI 1154596013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093828824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 DELTA RD",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600355204",
"telephone_number": "847-433-7367",
"fax_number": "630-305-7720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 E JEFFERSON AVE STE 205",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605408411",
"telephone_number": "630-355-7008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATKINSON",
"first_name": "CAROLYN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "71-2038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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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.