Individual provider Active NPI

Jennifer Lindskog, PSYD

  • Clinical Child & Adolescent Psychologist
  • Sycamore, IL
National Provider Identifier
1184059362
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
071.008921 Issued in IL
Practice address
760 Foxpointe Dr
Sycamore, IL 60178-3221
Phone
(815) 748-8334
NPI assigned
Sep 6, 2013
Last updated
Oct 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 071.008921 IL Primary

Addresses

Primary practice location

760 Foxpointe Dr
Sycamore, IL 60178-3221

Mailing address

760 Foxpointe Dr
Sycamore, IL 60178-3221

Other names 1

  • Jennifer Silverman Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260224000066 IL Order and Referring Only - Clinical Psychologist 3476034901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.008921ILMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kishwaukee Community Health Services Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1184059362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 FOXPOINTE DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 FOXPOINTE DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783221",
            "telephone_number": "815-748-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSKOG",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071.008921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SILVERMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.