Individual provider Active NPI

Ritu D Trivedi-Purohit, PSYD.

  • Clinical Psychologist
  • Park Ridge, IL
National Provider Identifier
1093896169
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007121 Issued in IL
Practice address
1440 Renaissance Dr
Suite 200
Park Ridge, IL 60068-1356
Phone
(847) 742-6041
Fax
(866) 565-9307
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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 071007121 IL Primary

Addresses

Primary practice location

1440 Renaissance Dr
Suite 200
Park Ridge, IL 60068-1356

Mailing address

549 Ivory LN
Bartlett, IL 60103-1230
Phone (847) 742-6041

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
I20070111000209 IL Practitioner - Clinical Psychologist 3173523487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1440 Renaissance Dr
Suite 220
Park Ridge, IL 60068-1452
Phone (847) 296-3442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Behavioral Health & Wellness, LLC Clinical CurrentSince Apr 10, 2007 Accepting new patients
M.H.R.C. Inc. Clinical Past Accepting new patients

Locations

1440 Renaissance Dr
Ste 200
Park Ridge, IL 60068
Phone (847) 296-3442

1440 Renaissance Dr
Ste 220
Park Ridge, IL 60068
Phone (847) 296-3442

Organizations & group practices 2

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1093896169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 IVORY LN",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031230",
            "telephone_number": "847-742-6041",
            "fax_number": "866-565-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR",
            "address_2": "SUITE 200",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681356",
            "telephone_number": "847-742-6041",
            "fax_number": "866-565-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVEDI-PUROHIT",
        "first_name": "RITU",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.