Individual provider Active NPI

Andrew Lee Collins Sr.

  • Family Psychologist
  • Chicago, IL
National Provider Identifier
1124933023
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family PsychologistTaxonomy code 103TF0000X
License
C452-0126-1030 Issued in IL
Practice address
2209 W Marquette Rd
Chicago, IL 60636-2539
Phone
(773) 630-4494
NPI assigned
Aug 17, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Psychologist 103TF0000X C452-0126-1030 IL Primary

Addresses

Primary practice location

2209 W Marquette Rd
Chicago, IL 60636-2539

Mailing address

2209 W Marquette Rd
Chicago, IL 60636-2539
Phone (773) 630-4494

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

NPI Registry JSON

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

{
    "created_epoch": "1786924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1124933023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 W MARQUETTE RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606362539",
            "telephone_number": "773-630-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 W MARQUETTE RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606362539",
            "telephone_number": "773-630-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "ANDREW",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-17",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "IL",
            "license": "C452-0126-1030",
            "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 Aug 17, 2026; 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.