Individual provider Active NPI

Steve Arthur Spaccarelli, PH.D.

  • Clinical Psychologist
  • Oak Park, IL
National Provider Identifier
1093880965
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
07004918 Issued in IL
Practice address
6551 North Ave
Oak Park, IL 60302-1020
Phone
(708) 969-2575
Fax
(708) 445-0495
NPI assigned
Nov 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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 07004918 IL Primary

Addresses

Primary practice location

6551 North Ave
Oak Park, IL 60302-1020

Mailing address

427 Lenox St
Oak Park, IL 60302-1339
Phone (708) 969-2575

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
I20100618000504 IL Practitioner - Clinical Psychologist 6204970858 Practice locations: Oak Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6551 N Ave
Oak Park, IL 60302-1020
Phone (708) 445-0480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
07004918ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rad Gharavi MD PC PastSince May 1, 2024 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": "1164240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1093880965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 LENOX ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021339",
            "telephone_number": "708-969-2575",
            "fax_number": "708-445-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021020",
            "telephone_number": "708-969-2575",
            "fax_number": "708-445-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPACCARELLI",
        "first_name": "STEVE",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-23",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "07004918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.