Individual provider Active NPI

Sangeeta Subhash Bookseller, PSY.D.

  • Clinical Psychologist
  • Tinley Park, IL
National Provider Identifier
1124415385
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.009042 Issued in IL
Practice address
16325 Harlem Ave
Suite 200
Tinley Park, IL 60477-2509
Phone
(708) 429-6999
Fax
(708) 429-6909
NPI assigned
Apr 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.009042 IL Primary

Addresses

Primary practice location

16325 Harlem Ave
Suite 200
Tinley Park, IL 60477-2509

Mailing address

16325 Harlem Ave
Suite 200
Tinley Park, IL 60477-2509
Phone (708) 429-6999

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

State licenses

LicenseStateTypeSpecialty
071.009042ILMDClinical Psychologist

Interoperability endpoints

  • Direct secure messaging: sangeeta.bookseller.1@11074.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1124415385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16325 HARLEM AVE",
            "address_2": "SUITE 200",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772509",
            "telephone_number": "708-429-6999",
            "fax_number": "708-429-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16325 HARLEM AVE",
            "address_2": "SUITE 200",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772509",
            "telephone_number": "708-429-6999",
            "fax_number": "708-429-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKSELLER",
        "first_name": "SANGEETA",
        "middle_name": "SUBHASH",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; 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.