Amy Fayazrad & Associates, PC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

AMY FAYAZRAD & ASSOCIATES, PC

Practice address

3633 W Lake Ave Ste 306
Glenview, IL 60026-5803

Phone

(760) 831-1191

NPI assigned

Jul 17, 2017

Last updated

Jul 17, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Amy Fayazrad Fayazrad

Title

President

Phone

(760) 831-1191

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Fayazrad, PSY.D.

  • Mental Health Counselor
  • Arlington Heights, IL
  • NPI 1043440910
  Medicare reassignment NPD

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500249600000",
    "number": "1184147647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4137 N MEADE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606341506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE STE 306",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265803",
            "telephone_number": "760-831-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY FAYAZRAD & ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-07-17",
        "status": "A",
        "authorized_official_last_name": "FAYAZRAD",
        "authorized_official_first_name": "AMY FAYAZRAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-831-1191",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Lynn Anderson, ATC
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• Psychologist in Glenview, IL
• Providers in Glenview, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.