NPIMap

Organization Active NPI

Personal Growth Associates, Inc.

  • Psychologist
  • Schaumburg, IL
National Provider Identifier
1184643124
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PERSONAL GROWTH ASSOCIATES, INC.
Practice address
919 N Plum Grove Rd
Suite C
Schaumburg, IL 60173-5144
Phone
(847) 413-9700
Fax
(847) 413-1701
NPI assigned
Jul 19, 2006
Last updated
Jan 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Authorized official

Name
Ginger Larson
Title
Billing Manager
Phone
(847) 413-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

919 N Plum Grove Rd
Suite C
Schaumburg, IL 60173-5144

Mailing address

919 N Plum Grove Rd
Suite C
Schaumburg, IL 60173-5144
Phone (847) 413-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050126000387 IL Part B Supplier - Clinic/Group Practice 8921058140 Receives reassigned benefits from 16 practitioners
Practice locations: Schaumburg, IL

National Provider Directory

National Provider Directory

Locations

1095 Pingree Rd
Ste 210
Crystal Lake, IL 60014
Phone (847) 413-9700

1111 N Plaza Dr
Ste 780
Schaumburg, IL 60173
Phone (847) 413-9700

919 N Plum Grove Rd
Ste C
Schaumburg, IL 60173
Phone (847) 413-9700

148 W Washington St
Ste 100
West Chicago, IL 60185

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358726400000",
    "number": "1184643124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 N PLUM GROVE RD",
            "address_2": "SUITE C",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735144",
            "telephone_number": "847-413-9700",
            "fax_number": "847-413-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 N PLUM GROVE RD",
            "address_2": "SUITE C",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735144",
            "telephone_number": "847-413-9700",
            "fax_number": "847-413-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL GROWTH ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-01-21",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "GINGER",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "847-413-9700"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; 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.