Individual provider Active NPI

Howard K Weissman, PSY.D.

  • Clinical Psychologist
  • Northbrook, IL
National Provider Identifier
1205988045
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-004710 Issued in IL
Practice address
899 Skokie Blvd Ste 430
Northbrook, IL 60062-4024
Phone
(847) 412-0922
Fax
(847) 412-0756
NPI assigned
Jan 18, 2007
Last updated
Aug 28, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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 071-004710 IL Primary

Addresses

Primary practice location

899 Skokie Blvd Ste 430
Northbrook, IL 60062-4024

Mailing address

899 Skokie Blvd Ste 430
Northbrook, IL 60062-4024
Phone (847) 412-0922

Other identifiers 1

IdentifierTypeStateIssuer
0001604762OtherILBLUECROSS BLUE SHEILD

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
I20071018000193 IL Practitioner - Clinical Psychologist 5294821500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1440 Techny Rd
Northbrook, IL 60062-5447
Phone (847) 412-0922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-004710ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Chicago Stress Relief Center, Inc Clinical CurrentSince May 1, 1993 Accepting new patients

Locations

1440 Techny Rd
Northbrook, IL 60062
Phone (847) 412-0922

899 Skokie Blvd
Ste 430
Northbrook, IL 60062
Phone (847) 272-7089

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1205988045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 SKOKIE BLVD STE 430",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624024",
            "telephone_number": "847-412-0922",
            "fax_number": "847-412-0756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 SKOKIE BLVD STE 430",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624024",
            "telephone_number": "847-412-0922",
            "fax_number": "847-412-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSMAN",
        "first_name": "HOWARD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-004710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHEILD",
            "identifier": "0001604762",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.