Individual provider Active NPI

Valentina Marie Pacheco-Cornejo, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1124453394
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009585 Issued in IL
Practice address
11848 S Western Ave
Chicago, IL 60643-4734
Phone
(773) 431-0486
NPI assigned
Sep 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 071009585 IL Primary

Addresses

Primary practice location

11848 S Western Ave
Chicago, IL 60643-4734

Mailing address

6011 S Menard Ave
Chicago, IL 60638-4419
Phone (773) 431-0486

Other practice location 1

6011 S Menard Ave
Chicago, IL 60638-4419
Phone (773) 431-0486

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Valentina, LLC Current Accepting new patients
Dr. Valentina, LLC Clinical CurrentSince Nov 1, 2023 Accepting new patients

Locations

11848 S Western Ave
Chicago, IL 60643
Phone (773) 366-3437

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1124453394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 S MENARD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606384419",
            "telephone_number": "773-431-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11848 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434734",
            "telephone_number": "773-431-0486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6011 S Menard Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606384419",
            "country_code": "US",
            "telephone_number": "773-431-0486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACHECO-CORNEJO",
        "first_name": "VALENTINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 14, 2025; 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.