Donna Ruth Amstutz, PHD
Individual provider Active NPI Clinical Psychologist · Wheaton, IL
NPI 1124187588 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124187588
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Practice address
- 610 W Roosevelt Rd
Suite D2
Wheaton, IL 60187 - Phone
- (630) 510-9225
- Fax
- (630) 510-0669
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091116000297 | IL | Practitioner - Clinical Psychologist | 7911045778 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IL071004054 | IL | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | IL | Yes |
Addresses
Primary practice location
610 W Roosevelt Rd
Suite D2
Wheaton, IL 60187
Mailing address
610 W Roosevelt Rd
Suite D2
Wheaton, IL 60187
Phone (630) 510-9225
Other providers in Wheaton, IL
- Ronald E Ambrogi
- American Drug Stores LLC
- American Drug Stores LLC
- Alkaben Dwijen Amin
- Diane Amstutz
- Sonika Anand
- Randolph Paul Andersen
- Shannon Andersen
- Susan J Anderson-Nelson
- Africa C Anderson
All providers in Wheaton, IL · Clinical Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.