Individual provider Active NPI

Jeffrey Brian Gersten, PSYD

  • Family Psychologist
  • Skokie, IL
National Provider Identifier
1124127006
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family PsychologistTaxonomy code 103TF0000X
License
0710006514 Issued in IL
Practice address
5550 Touhy Ave Ste 404
Skokie, IL 60077-3227
Phone
(847) 329-9210
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Psychologist 103TF0000X 0710006514 IL Primary

Addresses

Primary practice location

5550 Touhy Ave Ste 404
Skokie, IL 60077-3227

Mailing address

5550 Touhy Ave Ste 404
Skokie, IL 60077-3227
Phone (847) 329-9210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0710006514ILMDFamily Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Behavioral Health Group, P.C. CurrentSince Nov 12, 2023 Accepting new patients

Locations

1801 W Warner Ave
Ste 204
Chicago, IL 60613
Phone (847) 208-3802

5550 Touhy Ave
Ste 404
Skokie, IL 60077
Phone (773) 466-0847

Interoperability endpoints

  • Direct secure messaging: jgersten237583@direct.myadvocateaurora.org

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1124127006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 TOUHY AVE STE 404",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773227",
            "telephone_number": "847-329-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 TOUHY AVE STE 404",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773227",
            "telephone_number": "847-329-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSTEN",
        "first_name": "JEFFREY",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "IL",
            "license": "0710006514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.