Individual provider Active NPI

Ronald Peter Graef, PH.D.

  • Clinical Psychologist
  • Glenview, IL
National Provider Identifier
1235148206
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-002640 Issued in IL
Practice address
3633 W Lake Ave
Ste 201B
Glenview, IL 60026-5802
Phone
(847) 724-2730
Fax
(847) 724-2738
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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 071-002640 IL Primary

Addresses

Primary practice location

3633 W Lake Ave
Ste 201B
Glenview, IL 60026-5802

Mailing address

3633 W Lake Ave
Ste 201B
Glenview, IL 60026-5802
Phone (847) 724-2730

Other identifiers 1

IdentifierTypeStateIssuer
F300158965OtherILMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-002640ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stark Inch Associates, Inc. PastSince Apr 1, 2000 Accepting new patients

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1235148206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "STE 201B",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265802",
            "telephone_number": "847-724-2730",
            "fax_number": "847-724-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "STE 201B",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265802",
            "telephone_number": "847-724-2730",
            "fax_number": "847-724-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAEF",
        "first_name": "RONALD",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-002640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F300158965",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.