Active NPI
Susan J Duma, PSYD, MPH
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1174693667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2010030833
- Practice address
- 1142 W Madison St
Suite 406
Chicago, IL 60607-2023 - Phone
- (773) 599-9746
- NPI assigned
- Nov 9, 2006
- Last updated
- May 10, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2010030833 | MO | Primary |
Addresses
Primary practice location
1142 W Madison St
Suite 406
Chicago, IL 60607-2023
Mailing address
1142 W Madison St
Suite 406
Chicago, IL 60607-2023
Phone (773) 599-9746
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1142 W Madison St
Suite 406
Chicago, IL 60607-2191
Phone (773) 599-9746
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010030833 | MO | MD | Clinical Psychologist |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Chicago, IL
- NPI 1245615582
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462838400000",
"number": "1174693667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1142 W MADISON ST",
"address_2": "SUITE 406",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606072023",
"telephone_number": "773-599-9746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1142 W MADISON ST",
"address_2": "SUITE 406",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606072023",
"telephone_number": "773-599-9746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUMA",
"first_name": "SUSAN",
"middle_name": "J",
"credential": "PSYD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2016-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2010030833",
"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 May 10, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.