Joseph W. Byrne, PSY.D.
Individual provider Active NPI Clinical Psychologist · Northfield, IL
NPI 1124300470 · NPPES record last updated Mar 20, 2018
Key facts
- NPI
- 1124300470
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 071.009613 (IL)
- Practice address
- 456 W Frontage Rd Ste 232
Northfield, IL 60093-3034 - Phone
- (847) 644-1210
- NPI assigned
- Sep 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| I20210621003342 | IL | Order and Referring Only - Clinical Psychologist | 6608276191 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.009613 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Psychological Services | Clinical | Current | Accepting new patients |
Locations
456 W Frontage Rd
Ste 232
Northfield, IL 60093
Phone (847) 644-1210
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.009613 | IL | Yes |
Addresses
Primary practice location
456 W Frontage Rd Ste 232
Northfield, IL 60093-3034
Mailing address
456 W Frontage Rd Ste 232
Northfield, IL 60093-3034
Phone (847) 644-1210
Other providers in Northfield, IL
- Bryan Bugay, LCPC
- Bryn W. Jessup, PHD, PC
- Iryna Bugay
- Tia Burel
- Andrea J Burruss
- Ann Bystedt
- John Raymond Cahill III
- Virginia Calderon
- Judy Ann Callans
- Daniel Callistein
All providers in Northfield, 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 Mar 20, 2018. 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.