Active NPI
Nina Gritzalis, PSYD
- Clinical Psychologist
- Orland Park, IL
National Provider Identifier
1194863951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.006039
- Practice address
- 14716 Holly CT
Orland Park, IL 60462-3164 - Phone
- (708) 212-3335
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.006039 | IL | Primary |
Addresses
Primary practice location
14716 Holly CT
Orland Park, IL 60462-3164
Mailing address
14716 Holly CT
Orland Park, IL 60462-3164
Phone (708) 212-3335
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1632837 | Other | IL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.006039 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453161600000",
"number": "1194863951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14716 HOLLY CT",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623164",
"telephone_number": "708-212-3335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14716 HOLLY CT",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623164",
"telephone_number": "708-212-3335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRITZALIS",
"first_name": "NINA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2016-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.006039",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1632837",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.