Susan Christine Valessares, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071-006810 Issued in IL

Practice address

3 Squire LN
St Charles, IL 60174-1413

Phone

(630) 881-7601

Fax

(630) 513-6839

NPI assigned

Apr 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  Medicare reassignment NPD
• S. C. Valessares, Psy.D., Inc.

  • Clinical Neuropsychologist
  • St Charles, IL
  • NPI 1962666362
  NPD (past) Authorized official
• Central Dupage Physician Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1114040227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SQUIRE LN",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741413",
            "telephone_number": "630-881-7601",
            "fax_number": "630-513-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SQUIRE LN",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741413",
            "telephone_number": "630-881-7601",
            "fax_number": "630-513-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALESSARES",
        "first_name": "SUSAN",
        "middle_name": "CHRISTINE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071-006810",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "IL",
            "license": "071-006810",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071-006810",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Lynn Upchurch, PMHNP
• Joy O Urubusi, MD
• Sherenaz Pyarali Vaiya, M.A.CCC-SLP
• Laura Anne Valaitis, M.A.
• Crystal Vale, RBT
• Valley Ambulatory Surgery Center Anesthesiology LTD
• Valley Ambulatory Surgery Center, LP
• Valley Family Medicine, S.C.
• Valley Medical Inn
• Values Based Psychiatry

• Clinical Neuropsychologist in St Charles, IL
• Providers in St Charles, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.