Kristin Ridder, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.010166 Issued in IL

Practice address

4043 N Ravenswood Ave Ste 302
Chicago, IL 60613-5683

Phone

(630) 773-8595

NPI assigned

Nov 11, 2019

Last updated

Nov 11, 2019By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Bucktown Therapy

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1962032086
  NPD Authorized official

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1134764400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 N RAVENSWOOD AVE STE 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135683",
            "telephone_number": "630-877-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4043 N RAVENSWOOD AVE STE 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135683",
            "telephone_number": "630-773-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDER",
        "first_name": "KRISTIN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maritza Rico, LCPC
• Rebeca M Rico, MD
• Renalyn Rico, RPT
• Timothy Riddell, PA-C
• Jennifer Anne Ridder, LPC
• Paige L Ridder, OTR
• Riddhi J Desai DMD PLLC
• Carrah Rose Riddle, LCSW
• Kirk Remon Riddle, LICENSED PROFESSIONA
• Ride Ez

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; 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.