Active NPI
Gary Coleman, Psy.D. & Associates
- Clinical Psychologist
- Aurora, IL
National Provider Identifier
1114181971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-006641
- Legal business name
- GARY COLEMAN, PSY.D. & ASSOCIATES
- Practice address
- 2114 Deerpath Rd
Aurora, IL 60506-7943 - Phone
- (630) 907-1735
- NPI assigned
- Jul 10, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gary Lee Coleman, PSY. D.
- Title
- Psychologist
- Phone
- (630) 907-1735
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071-006641 | IL | Primary |
Addresses
Primary practice location
2114 Deerpath Rd
Aurora, IL 60506-7943
Mailing address
2114 Deerpath Rd
Aurora, IL 60506-7943
Phone (630) 907-1735
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04523608 | Other | IL | BLUE CROSS & BLUE SHIELD |
| 1407994049 | Other | IL | NPI TYPE I |
National Provider Directory
National Provider DirectoryLocations
2114 Deerpath Rd
Aurora, IL 60506
Phone (630) 907-1735
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Psychologist
- Aurora, IL
- NPI 1407994049
-
- Psychiatry Physician
- Aurora, IL
- NPI 1548322639
-
- Social Worker
- Sugar Grove, IL
- NPI 1396097168
-
- Mental Health Counselor
- Aurora, IL
- NPI 1477812097
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1215648000000",
"number": "1114181971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2114 DEERPATH RD",
"city": "AURORA",
"state": "IL",
"postal_code": "605067943",
"telephone_number": "630-907-1735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2114 DEERPATH RD",
"city": "AURORA",
"state": "IL",
"postal_code": "605067943",
"telephone_number": "630-907-1735"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GARY COLEMAN, PSY.D. & ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-10",
"last_updated": "2008-07-10",
"status": "A",
"authorized_official_last_name": "COLEMAN",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "PSYCHOLOGIST",
"authorized_official_telephone_number": "630-907-1735",
"authorized_official_credential": "PSY. D."
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-006641",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "04523608",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI TYPE I",
"identifier": "1407994049",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.