Individual provider Active NPI

Randi Nell Sax, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1215330154
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.004779 Issued in IL
Practice address
845 N Michigan Ave Ste 973W
Chicago, IL 60611-2218
Phone
(312) 878-8800
Fax
(312) 448-9978
NPI assigned
Oct 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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 071.004779 IL Primary

Addresses

Primary practice location

845 N Michigan Ave Ste 973W
Chicago, IL 60611-2218

Mailing address

845 N Michigan Ave Ste 973W
Chicago, IL 60611-2218
Phone (312) 878-8800

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
I20141113001656 IL Practitioner - Clinical Psychologist 9739301458 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
Group practices
Revolution PTWL LLCGroup PAC ID 7719115617, 42 clinicians

Practice addresses (Care Compare)

2200 Waukegan Rd
Glenview, IL 60025-1759
Phone (312) 878-8800

2216 W N Ave
Chicago, IL 60647-6494
Phone (312) 878-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.004779ILMDClinical Psychologist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1215330154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 N MICHIGAN AVE STE 973W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112218",
            "telephone_number": "312-878-8800",
            "fax_number": "312-448-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 N MICHIGAN AVE STE 973W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112218",
            "telephone_number": "312-878-8800",
            "fax_number": "312-448-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAX",
        "first_name": "RANDI NELL",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.004779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.