NPIMap

Organization Active NPI

Chicago Neurorehabilitation Center LLC

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1114334547
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008380 Issued in IL
Legal business name
CHICAGO NEUROREHABILITATION CENTER LLC
Practice address
980 N Michigan Ave
Suite 1400
Chicago, IL 60611-4501
Phone
(312) 504-4428
NPI assigned
Jul 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Authorized official

Name
Dr. Michelle London, PSYD
Title
Sole MBR
Phone
(312) 504-4428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 071008380 IL Primary

Addresses

Primary practice location

980 N Michigan Ave
Suite 1400
Chicago, IL 60611-4501

Mailing address

6033 N Sheridan Rd
Suite N6
Chicago, IL 60660-3003
Phone (312) 504-4428

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1114334547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 N SHERIDAN RD",
            "address_2": "SUITE N6",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603003",
            "telephone_number": "312-504-4428",
            "fax_number": "773-751-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 N MICHIGAN AVE",
            "address_2": "SUITE 1400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114501",
            "telephone_number": "312-504-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO NEUROREHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "LONDON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "312-504-4428",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008380",
            "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 Jul 22, 2014; 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.