Paul Flores, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.010859 Issued in IL

Practice address

200 W Monroe St Ste 308
Bloomington, IL 61701-3997

Phone

(309) 204-6766

NPI assigned

Apr 5, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Williams Psychological Services PLLC

  • Health Service Psychologist
  • Bloomington, IL
  • NPI 1366170755
  NPD

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1124713292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 BERKLEY RD",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617619550",
            "telephone_number": "626-344-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W MONROE ST STE 308",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013997",
            "telephone_number": "309-204-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Ann Fitzgerald, M.D.
• Hollie Ann Flesher
• Deborah Elaine Flockerzi, LPC
• Kenneth James Florence, OTA
• Karyn W Flores
• Cathy Flynn
• Ashleigh Maye Fogarty
• Erica Jayne Fogarty
• Sarah Michelle Follmer, DPT
• Victoria N Folse, PHD, APN, LCPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.