Individual provider Active NPI

Melanie Louise Terbovic, PH.D.

  • Clinical Psychologist
  • Lake Zurich, IL
National Provider Identifier
1194703041
Registry record updated Mar 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-006258 Issued in IL
Practice address
1 Golfview Rd
Suite 4
Lake Zurich, IL 60047-1210
Phone
(847) 726-1400
Fax
(847) 726-2409
NPI assigned
Jan 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-006258 IL Primary

Addresses

Primary practice location

1 Golfview Rd
Suite 4
Lake Zurich, IL 60047-1210

Mailing address

1 Golfview Rd
Suite 4
Lake Zurich, IL 60047-1210
Phone (847) 726-2400

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
I20050803000928 IL Practitioner - Clinical Psychologist 0941238588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clocktower Psychological Associates LTDGroup PAC ID 5991885675, 5 clinicians

Practice addresses (Care Compare)

1 Golfview Rd
Suite 4
Lake Zurich, IL 60047-1210
Phone (847) 726-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-006258ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clocktower Psychological Associates, LTD. CurrentSince Dec 3, 2007 Accepting new patients
Aspen Behavioral Care Clinical PastSince Jul 31, 2013 Accepting new patients

Locations

1 Golfview Rd
Ste 1
Lake Zurich, IL 60047
Phone (224) 639-3246

1 Golfview Rd
Ste 4
Lake Zurich, IL 60047
Phone (847) 726-1400

Organizations & group practices 2

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": "1136073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237334400000",
    "number": "1194703041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GOLFVIEW RD",
            "address_2": "SUITE 4",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600471210",
            "telephone_number": "847-726-2400",
            "fax_number": "847-726-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GOLFVIEW RD",
            "address_2": "SUITE 4",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600471210",
            "telephone_number": "847-726-1400",
            "fax_number": "847-726-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERBOVIC",
        "first_name": "MELANIE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-01",
        "last_updated": "2009-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-006258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Zurich, IL

Sources for this page

Verify at the official NPI Registry.