Kim Delayne Grant

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009195 Issued in IL

Practice address

2625 Butterfield Rd
Suite 101N
Oak Brook, IL 60523-1234

Phone

(630) 586-0900

NPI assigned

Mar 5, 2017

Last updated

Mar 5, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kim D. Grant Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 25, 2024 through Jul 25, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Perrotta and Kraus PHDS PC

  dba Centers for Family Change

  • Psychologist
  • Oak Brook, IL
  • NPI 1295928968
  NPD (past)

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

{
    "created_epoch": "1488672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488672000000",
    "number": "1164962502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "SUITE 101N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-586-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "SUITE 101N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-586-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "KIM",
        "middle_name": "DELAYNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-05",
        "last_updated": "2017-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "GRANT",
            "middle_name": "D.",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Robert Eugene Gorsich, M.D.
• Thomas M Gosche, DPT
• Sabrina R Gosmire, LCPC
• Grace Integrated, LLC
• Carol Ann Grandstaff, L.C.P.C.
• Myra Grant
• Jennifer M Gray, AAS
• Tynaya N Gray, LPN
• Great Oaks Medical Care SC
• Matthew Ryan Greenberg, D.C.

• Clinical Psychologist in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.