Birchwood Clinic, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009612 Issued in IL

Legal business name

BIRCHWOOD CLINIC, LLC

Practice address

2302 W North Ave Ste 1E
Chicago, IL 60647-9755

Phone

(312) 806-2140

NPI assigned

Oct 4, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Susan Marie Bush, PSYDNPI 1588183263

Title

Psychologist, Owner

Phone

(312) 806-2140

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Marie Bush, PSYD

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1588183263
  NPD Authorized official

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507075200000",
    "number": "1104336114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 W NORTH AVE STE 1E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606479755",
            "telephone_number": "312-806-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 W NORTH AVE STE 1E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606479755",
            "telephone_number": "312-806-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIRCHWOOD CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PSYCHOLOGIST, OWNER",
        "authorized_official_telephone_number": "312-806-2140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Lynn Birch, M.D.
• Kristina Nielsen Birch, DPT
• Noah Warren Birch, M.D., PH.D.
• Lindsay Birchfield, RD
• Maia Birchmoon-Gordon, RN, IBCLC
• Birchwood Plaza Inc.
• Joshua M. Bird-Martinez, LCSW
• Michael Bird, APRN
• Paige C Bird
• Steven J Bird

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.