Individual provider Active NPI

Mark A Bakal, PSY.D.

  • Psychologist
  • Schaumburg, IL
National Provider Identifier
1104925239
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
919 N Plum Grove Rd
Suite C
Schaumburg, IL 60173-5144
Phone
(847) 413-9700
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X IL Primary

Addresses

Primary practice location

919 N Plum Grove Rd
Suite C
Schaumburg, IL 60173-5144

Mailing address

919 N Plum Grove Rd
Suite C
Schaumburg, IL 60173-5144
Phone (847) 413-9700

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
I20080407000458 IL Practitioner - Clinical Psychologist 1759468333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Growth Associates, Inc.Group PAC ID 8921058140, 13 clinicians

Practice addresses (Care Compare)

919 N Plum Grove Rd
Suite C
Schaumburg, IL 60173-4760
Phone (847) 413-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-005737ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Growth Associates, Inc. Psychologist CurrentSince Jan 9, 2008 Accepting new patients

Locations

919 N Plum Grove Rd
Ste C
Schaumburg, IL 60173
Phone (847) 413-9700

Organizations & group practices 1

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104925239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 N PLUM GROVE RD",
            "address_2": "SUITE C",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735144",
            "telephone_number": "847-413-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 N PLUM GROVE RD",
            "address_2": "SUITE C",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735144",
            "telephone_number": "847-413-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKAL",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.