Integrative Psychological Services, Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006449 Issued in IL

Legal business name

INTEGRATIVE PSYCHOLOGICAL SERVICES, INC

Practice address

100 N Atkinson Rd Ste 106
Grayslake, IL 60030-7805

Phone

(224) 577-5308

Fax

(847) 543-6932

NPI assigned

May 15, 2007

Organization subpart

No

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

Authorized official

Name

Victoria McCarthy

Title

Office Manager

Phone

(224) 430-1918

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lawrence Todryk, PSY.D.

  • Clinical Psychologist
  • Grayslake, IL
  • NPI 1326164377
  Medicare reassignment NPD

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1205042652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 BELLE CT",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302301",
            "telephone_number": "224-577-5308",
            "fax_number": "847-543-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ATKINSON RD STE 106",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600307805",
            "telephone_number": "224-577-5308",
            "fax_number": "847-543-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE PSYCHOLOGICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2024-01-16",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "224-430-1918"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.