Robert Ida, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071009564 Issued in IL

Practice address

1749 S Naperville Rd
Suite 106
Wheaton, IL 60189-5892

Phone

(630) 260-8780

Fax

(630) 938-4697

NPI assigned

Apr 19, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neurocare and Family Services PCGroup PAC ID 6103127154, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Neurocare and Family Services P.C.

  • Clinical Neuropsychologist
  • Wheaton, IL
  • NPI 1699050435
  Medicare reassignment Care Compare group NPD
• Specialty Psychology P.C.

  • Clinical Neuropsychologist
  • Arlington Heights, IL
  • NPI 1124857073
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1225562986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 S NAPERVILLE RD",
            "address_2": "SUITE 106",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 S NAPERVILLE RD",
            "address_2": "SUITE 106",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895892",
            "telephone_number": "630-260-8780",
            "fax_number": "630-938-4697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2445 Dean St Ste 1A",
            "address_purpose": "LOCATION",
            "city": "St Charles",
            "state": "IL",
            "postal_code": "601754828",
            "country_code": "US",
            "telephone_number": "847-738-0250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDA",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071009564",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009564",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyder Counseling and Consulting
• Katherine Sarah Sengoba Hyon, M.D.
• Abby Lynn Ianakiev, MD
• Rachel Ibrahim
• Icare4Vision LLC
• Mary J Iffert, NCSP
• Amanda Iglesias
• Maria Ilic, M.D.
• Illinois Urological Institute
• Syeda Imam

• Clinical Neuropsychologist in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.