Individual provider Active NPI

Carly Rosenberg, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1184083503
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071011469 Issued in IL
Practice address
500 N Michigan Ave Ste 1400
Chicago, IL 60611-3759
Phone
(630) 428-7890
NPI assigned
Feb 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178011735 IL
Clinical Psychologist 103TC0700X 071011469 IL Primary

Addresses

Primary practice location

500 N Michigan Ave Ste 1400
Chicago, IL 60611-3759

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
Phone (630) 428-7890

Other practice location 1

2845 N Sheridan Road
Suite 809
Chicago, IL 60657
Phone (877) 384-0635

Other practice location 2

2071 N Southport Ave Ste 100
Chicago, IL 60614-4015
Phone (630) 428-7890

Other practice location 3

7900 Cass Ave Ste 200
Darien, IL 60561-5073
Phone (630) 428-7890

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
I20251010000594 IL Practitioner - Clinical Psychologist 7315444783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

500 N Michigan Avennue
Suite 1400
Chicago, IL 60611-3707
Phone (888) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178011735ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. CurrentSince Aug 4, 2025 Accepting new patients
Edgewood Clinical Services, P.C. Past Accepting new patients
Psychology Specialists LTD Clinical Past Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

808 S Eldorado Rd
Ste 300
Bloomington, IL 61704
Phone (309) 827-2962

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

2845 N Sheridan Rd
Ste 809
Chicago, IL 60657
Phone (312) 761-4721

500 N Michigan Ave
Ste 1400
Chicago, IL 60611
Phone (312) 761-4755

1616 N Damen Ave
Ste 301
Chicago, IL 60647
Phone (312) 761-4720

7900 Cass Ave
Ste 200
Darien, IL 60561
Phone (630) 581-7134

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

175 E Hawthorne Pkwy
Ste 235
Vernon Hills, IL 60061
Phone (847) 865-4125

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.carlyrosenberg@146897.advancedmd-direct.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1184083503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "630-428-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N MICHIGAN AVE STE 1400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113759",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2845 N Sheridan Road",
            "address_2": "Suite 809",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60657",
            "country_code": "US",
            "telephone_number": "877-384-0635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2071 N SOUTHPORT AVE STE 100",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606144015",
            "country_code": "US",
            "telephone_number": "630-428-7890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7900 Cass Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Darien",
            "state": "IL",
            "postal_code": "605615073",
            "country_code": "US",
            "telephone_number": "630-428-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "CARLY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178011735",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071011469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.