Andrew Glenn Beatty, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007983 Issued in IL

Practice address

2900 N Lake Shore Dr FL 9
Chicago, IL 60657-5640

Phone

(773) 665-4836

NPI assigned

Oct 29, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fox Valley Institute for Growth and Wellness IncGroup PAC ID 0244285617, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Valley Institute for Growth and Wellness Inc

  • Counselor
  • Naperville, IL
  • NPI 1174637334
  Medicare reassignment Care Compare group NPD
• Revelations RX PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Naperville, IL
  • NPI 1265124846
  NPD
• J F Zagotta & Associates LLC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1518984327
  NPD (past)

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1124328752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 N HALSTED ST STE 501",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422615",
            "telephone_number": "773-388-6390",
            "fax_number": "312-867-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR FL 9",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-665-4836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1460 N Halsted St Ste 501",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606422615",
            "country_code": "US",
            "telephone_number": "773-388-6390",
            "fax_number": "312-867-7101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEATTY",
        "first_name": "ANDREW",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Kemp Beasley, RN
• Beata S Bednarska MD PC
• Beatrice Home Health, Inc.
• Beats Health Inc
• Elizabeth Shea Beatty Kwarta, ELIZABETH BEATTY RD
• Dana L Beatty, CNM CERTIFIED NURSE
• Melanie Beatty, M.S.,CCC-SLP
• Sarah Gallagher Beatty, LCSW
• Ashley Crystal Beaty, CPHT
• Deborah Lorene Beaty, DDS

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.