Active NPI
Tal Raviv, PHD
- Psychologist
- Chicago, IL
National Provider Identifier
1124350418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071.007797
- Practice address
- 2300 N Childrens PLZ
Box 10
Chicago, IL 60614-3363 - Phone
- (773) 880-4827
- Fax
- (773) 880-8110
- NPI assigned
- Feb 11, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071.007797 | IL | Primary |
| Psychologist | 103T00000X | 3336 | CO |
Addresses
Primary practice location
2300 N Childrens PLZ
Box 10
Chicago, IL 60614-3363
Mailing address
2300 N Childrens PLZ
Box 10
Chicago, IL 60614-3363
Phone (773) 880-4827
Other names 1
- Tali Raviv
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.007797 | IL | MD | Psychologist |
| 3336 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265846400000",
"number": "1124350418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 N CHILDRENS PLZ",
"address_2": "BOX 10",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606143363",
"telephone_number": "773-880-4827",
"fax_number": "773-880-8110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 N CHILDRENS PLZ",
"address_2": "BOX 10",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606143363",
"telephone_number": "773-880-4827",
"fax_number": "773-880-8110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAVIV",
"first_name": "TAL",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-11",
"last_updated": "2010-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071.007797",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "3336",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TALI",
"last_name": "RAVIV",
"credential": "PHD",
"code": "5",
"type": "Other Name"
}
]
}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 Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.