Organization Active NPI

Dr. Robert E. Puls, P.C.

  • Clinical Psychologist
  • New Lenox, IL
National Provider Identifier
1093839433
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DR. ROBERT E. PULS, P.C.
Practice address
1352 N Cedar Rd
New Lenox, IL 60451-1163
Phone
(815) 463-8805
Fax
(815) 463-8806
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert E Puls, PSY.D.NPI 1992850044
Title
Clinical Psychologist
Phone
(815) 463-8805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X IL Primary

Addresses

Primary practice location

1352 N Cedar Rd
New Lenox, IL 60451-1163

Mailing address

1352 N Cedar Rd
New Lenox, IL 60451-1163
Phone (815) 463-8805

Other identifiers 1

IdentifierTypeStateIssuer
1992850044OtherILPERSONAL NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070411000112 IL Part B Supplier - Clinic/Group Practice 5597860171 Receives reassigned benefits from 1 practitioner
Practice locations: Orland Park, IL

National Provider Directory

National Provider Directory

Locations

5 Old Frankfort Way
Frankfort, IL 60423
Phone (708) 522-4815

1352 N Cedar Rd
New Lenox, IL 60451
Phone (815) 463-8805

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093839433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1352 N CEDAR RD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511163",
            "telephone_number": "815-463-8805",
            "fax_number": "815-463-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1352 N CEDAR RD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511163",
            "telephone_number": "815-463-8805",
            "fax_number": "815-463-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ROBERT E. PULS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PULS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "815-463-8805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1992850044",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.