Individual provider Active NPI

Tony A Fletcher, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1104854892
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-005279 Issued in IL
Practice address
53 W Jackson Blvd Ste 1522
Chicago, IL 60604-3761
Phone
(312) 961-9974
Fax
(312) 285-2151
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-005279 IL Primary
Clinical Neuropsychologist 103G00000X 071-005279 IL

Addresses

Primary practice location

53 W Jackson Blvd Ste 1522
Chicago, IL 60604-3761

Mailing address

1205 Linden Ave
Oak Park, IL 60302-1244
Phone (312) 961-9974

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-005279ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arrow Assessment & Consultation, PLLC Clinical Neuropsychologist Current Accepting new patients
Higgins & Carter LLC Past Accepting new patients
Davken Associates, P.C. Clinical Past Accepting new patients
Neuroclinic and Assessments, LLC Clinical Neuropsychologist PastSince Sep 25, 2012 Accepting new patients
Marianna Tsaran MD SC PastSince Jun 30, 2018 Accepting new patients
Rehabilitation Associates of the Midwest, S.C. Clinical Past Accepting new patients
In Home Health, LLC Past Accepting new patients

Locations

53 W Jackson Blvd
Ste 1522
Chicago, IL 60604
Phone (312) 961-9974

Organizations & group practices 7

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1104854892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 LINDEN AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021244",
            "telephone_number": "312-961-9974",
            "fax_number": "312-285-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD STE 1522",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043761",
            "telephone_number": "312-961-9974",
            "fax_number": "312-285-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "TONY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005279",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071-005279",
            "primary": false
        }
    ],
    "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 Jan 9, 2026; 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.