NPIMap

Organization Active NPI

Studio for Change

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1114180148
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-005837 Issued in IL
Legal business name
STUDIO FOR CHANGE
Practice address
2835 N Sheffield Ave Ste 310
Chicago, IL 60657-5084
Phone
(773) 281-8130
Fax
(773) 281-7150
NPI assigned
Jul 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Authorized official

Name
Julia M Rahn, PH.D.
Title
Owner
Phone
(773) 281-8130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 071-005837 IL Primary

Addresses

Primary practice location

2835 N Sheffield Ave Ste 310
Chicago, IL 60657-5084

Mailing address

2835 N Sheffield Ave Ste 310
Chicago, IL 60657-5084
Phone (773) 281-8130

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1114180148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 N SHEFFIELD AVE STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575084",
            "telephone_number": "773-281-8130",
            "fax_number": "773-281-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 N SHEFFIELD AVE STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575084",
            "telephone_number": "773-281-8130",
            "fax_number": "773-281-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUDIO FOR CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "RAHN",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-281-8130",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005837",
            "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 11, 2015; 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.