Active NPI
Russel Reizner
- Clinical Psychologist
- Northbrook, IL
National Provider Identifier
1194988766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.004888
- Practice address
- 3444 Dundee Rd
Northbrook, IL 60062-2201 - Phone
- (847) 559-0110
- Fax
- (847) 559-8199
- NPI assigned
- Jul 3, 2008
- Sex
- Male
- Sole proprietor
- No
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 | 071.004888 | IL | Primary |
Addresses
Primary practice location
3444 Dundee Rd
Northbrook, IL 60062-2201
Mailing address
3444 Dundee Rd
Northbrook, IL 60062-2201
Phone (847) 559-0110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1993
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5402 Green Glen LN
Alexandria, VA 22315-5517
831 Bedford Ave
Suite 530
Brooklyn, NY 11205-2801
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.004888 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rhodium Care Group Inc | Current | Accepting new patients | |
| Aspen Behavioral Care | Clinical | Past | Accepting new patients |
Locations
2729 King St
Alexandria, VA 22302
Phone (703) 744-0155
8830 Virginia St
Amelia Ct Hse, VA 23002
Phone (804) 561-5611
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": "1215043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215043200000",
"number": "1194988766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3444 DUNDEE RD",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622201",
"telephone_number": "847-559-0110",
"fax_number": "847-559-8199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3444 DUNDEE RD",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622201",
"telephone_number": "847-559-0110",
"fax_number": "847-559-8199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIZNER",
"first_name": "RUSSEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-03",
"last_updated": "2008-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.004888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.