Judy Koenigsberg, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Practice address

708 Church St
Evanston, IL 60201-3840

Phone

(312) 409-4222

NPI assigned

Dec 5, 2005

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 15, 2015 through Jun 15, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174507008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6907 N KOLMAR AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607124703",
            "telephone_number": "847-673-1421",
            "fax_number": "847-679-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 CHURCH ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013840",
            "telephone_number": "312-409-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIGSBERG",
        "first_name": "JUDY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Knuth, PHD
• Jessica Ko
• Jungyun Ko
• Mindy Sayo Kobara-Mates, PH.D., CCC-SP
• Omega Koch, DPT
• Ayodeji K Kofoworola, PT, DPT
• Alan D. Kogan, M.D.
• Ann E Kogen, L.C.S.W.
• Chau Ern Koh, DPT
• Eun-Kyu Koh, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.