Individual provider Active NPI

Rebecca Anne Parry, PSYD

  • Psychologist
  • Chicago, IL
National Provider Identifier
1104493394
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071010525 Issued in IL
Practice address
1950 N Damen Ave
Chicago, IL 60647-4565
Phone
(773) 598-9487
NPI assigned
Jun 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071010525 IL Primary

Addresses

Primary practice location

1950 N Damen Ave
Chicago, IL 60647-4565

Mailing address

3135 N Saint Louis Ave
Chicago, IL 60618-6725
Phone (786) 277-3948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071010525ILMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1104493394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 N SAINT LOUIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186725",
            "telephone_number": "786-277-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474565",
            "telephone_number": "773-598-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRY",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071010525",
            "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 Jun 7, 2021; 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.