Individual provider Active NPI

Peter Zeldow, PHD

  • Psychologist
  • Chicago, IL
National Provider Identifier
1144365610
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071002597 Issued in IL
Practice address
645 N Michigan Ave
Suite 822
Chicago, IL 60611-2826
Phone
(312) 618-9680
NPI assigned
Feb 21, 2007
Last updated
Dec 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071002597 IL Primary

Addresses

Primary practice location

645 N Michigan Ave
Suite 822
Chicago, IL 60611-2826

Mailing address

645 N Michigan Ave
Suite 822
Chicago, IL 60611-2826
Phone (312) 618-9680

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation PastSince Feb 1, 2013 Accepting new patients
Northwestern Medical Faculty Foundation Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1144365610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N MICHIGAN AVE",
            "address_2": "SUITE 822",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112826",
            "telephone_number": "312-618-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 N MICHIGAN AVE",
            "address_2": "SUITE 822",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112826",
            "telephone_number": "312-618-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELDOW",
        "first_name": "PETER",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071002597",
            "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 Dec 15, 2009; 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.