Active NPI
Ellen McGury Stone, PSY.D.
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1104050335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.006977
- Practice address
- 30 N. Michigan
1917
Chicago, IL 60602 - Phone
- (312) 965-4260
- NPI assigned
- May 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 071.006977 | IL | Primary |
Addresses
Primary practice location
30 N. Michigan
1917
Chicago, IL 60602
Mailing address
1863 W. 107TH St.
Unit C
Chicago, IL 60643
Phone (312) 965-4260
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100611000122 | IL | Practitioner - Clinical Psychologist | 3072643485 | Practice locations: Chicago, IL; Evergreen Park, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
9318 S Kedzie Ave
Suite 2
Evergreen Park, IL 60805-2323
Phone (773) 941-4479
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.006977 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241136000000",
"number": "1104050335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1863 W. 107TH ST.",
"address_2": "UNIT C",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60643",
"telephone_number": "312-965-4260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 N. MICHIGAN",
"address_2": "1917",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60602",
"telephone_number": "312-965-4260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STONE",
"first_name": "ELLEN",
"middle_name": "MCGURY",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-01",
"last_updated": "2009-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.006977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.