Active NPI
Paul William Goetz, PH.D.
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1134463706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.008459
- Practice address
- 201 E Huron St Ste 11-140
Chicago, IL 60611-2968 - Phone
- (312) 695-2734
- NPI assigned
- Nov 20, 2012
- Sex
- Male
- 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 | 071.008459 | IL | Primary |
Addresses
Primary practice location
201 E Huron St Ste 11-140
Chicago, IL 60611-2968
Mailing address
201 E Huron St Ste 11-140
Chicago, IL 60611-2968
Phone (312) 695-2734
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.008459 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1134463706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E HURON ST STE 11-140",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112968",
"telephone_number": "312-695-2734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 E HURON ST STE 11-140",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112968",
"telephone_number": "312-695-2734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOETZ",
"first_name": "PAUL",
"middle_name": "WILLIAM",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-11-20",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.008459",
"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 Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.