Organization Active NPI

Sheila Culkin, Inc

  • Psychologist
  • Evanston, IL
National Provider Identifier
1154620052
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071004669 Issued in IL
Legal business name
SHEILA CULKIN, INC
Practice address
636 Church St
Suite 405
Evanston, IL 60201-4508
Phone
(847) 328-3120
NPI assigned
Mar 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Authorized official

Name
Mrs. Sheila Mary Culkin, PHDNPI 1013040856
Title
Owner
Phone
(847) 328-3120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 071004669 IL Primary

Addresses

Primary practice location

636 Church St
Suite 405
Evanston, IL 60201-4508

Mailing address

1912 Lincoln St
Evanston, IL 60201-2206
Phone (847) 328-3120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110407000390 IL Part B Supplier - Clinic/Group Practice 6406030907 Receives reassigned benefits from 1 practitioner
Practice locations: Evanston, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300406400000",
    "number": "1154620052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 LINCOLN ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012206",
            "telephone_number": "847-328-3120",
            "fax_number": "847-869-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST",
            "address_2": "SUITE 405",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014508",
            "telephone_number": "847-328-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEILA CULKIN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-03-18",
        "status": "A",
        "authorized_official_last_name": "CULKIN",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-328-3120",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071004669",
            "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 Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.