Faan Yeen Sidor, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006645 Issued in IL

Practice address

3001A Sixth St.
BLDG 200H 4E
Great Lakes, IL 60088-2833

Phone

(847) 688-2755

Fax

(847) 688-2546

NPI assigned

Jan 25, 2007

Last updated

May 6, 2008By the provider in NPPES

Sex

Female

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Faan Yeen Sidor, Psy.D. LTD

  • Clinical Psychologist
  • Lincolnshire, IL
  • NPI 1720622624
  NPD Authorized official

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1134275282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001A SIXTH STREET",
            "address_2": "BLDG 200H 4E",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882833",
            "telephone_number": "847-688-2755",
            "fax_number": "847-688-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001A SIXTH ST.",
            "address_2": "BLDG 200H 4E",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882833",
            "telephone_number": "847-688-2755",
            "fax_number": "847-688-2546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDOR",
        "first_name": "FAAN YEEN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deeksha Sethi, D.M.D
• Bradley Shemluck, DDS
• Liam John Shields, DMD
• Kambez Shukoor, D.D.S.
• James Albert Shumaker Sr., IDC
• Bradford Lawrence Smith, M.D.
• Karen Shelburne Smith, D.M.D.
• Marc Gerald Smith, IDC
• Kortney Spectre
• Brett Staib, NAVY IDC

• Clinical Psychologist in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.