Ivan A. Wolfson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-005558 Issued in IL

Practice address

149 Oak Knoll Ter
Highland Park, IL 60035-5320

Phone

(847) 433-4450

Fax

(847) 433-5464

NPI assigned

Jan 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Wolfson Psychological Services, P.C.

  • Clinical Psychologist
  • Highland Park, IL
  • NPI 1194851477
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1136592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1205814456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 OAK KNOLL TER",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355320",
            "telephone_number": "847-433-4450",
            "fax_number": "847-433-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 OAK KNOLL TER",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355320",
            "telephone_number": "847-433-4450",
            "fax_number": "847-433-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFSON",
        "first_name": "IVAN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-07",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INCORPORATION FILENUMBER",
            "identifier": "5988-151-5",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Norman Wilner, MD
• Robert Withington
• Deborah Springman Wojcik, MSW, LCSW
• Lindsay Wolff, L.C.S.W.
• Wolfson Psychological Services, P.C.
• Wayne Wolkowicz, REGISTERED NURSE
• Wendy Wong
• Meredith Wood, L.M.F.T
• Michael T Woodall, MD
• Lisa Beth Woods, M.S., CCC-SLP

• Clinical Psychologist in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.

Verify at the official NPI Registry.