Active NPI
Katherine Sheila Metres, PSY.D.
- Clinical Psychologist
- Evanston, IL
National Provider Identifier
1134215627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-005370
- Practice address
- 2530 Crawford Ave
Suite 115
Evanston, IL 60201-4970 - Phone
- (847) 424-9110
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071-005370 | IL | Primary |
Addresses
Primary practice location
2530 Crawford Ave
Suite 115
Evanston, IL 60201-4970
Mailing address
2530 Crawford Ave
Suite 115
Evanston, IL 60201-4970
Phone (847) 424-9110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110801000072 | IL | Practitioner - Clinical Psychologist | 4587832969 | Practice locations: Lincolnshire, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
49 Cambridge LN
Lincolnshire, IL 60069-3104
Phone (847) 226-5285
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-005370 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280448000000",
"number": "1134215627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2530 CRAWFORD AVE",
"address_2": "SUITE 115",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602014970",
"telephone_number": "847-424-9110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2530 CRAWFORD AVE",
"address_2": "SUITE 115",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602014970",
"telephone_number": "847-424-9110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METRES",
"first_name": "KATHERINE",
"middle_name": "SHEILA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2010-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-005370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.