Individual provider Active NPI

Josette Wolthusen, PSYD

  • Clinical Psychologist
  • Arlington Heights, IL
National Provider Identifier
1235209214
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-005997 Issued in IL
Practice address
3413 N Kennicott Ave Ste a
Arlington Heights, IL 60004-7815
Phone
(847) 240-2211
NPI assigned
Nov 8, 2006
Last updated
Jul 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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 071-005997 IL Primary

Addresses

Primary practice location

3413 N Kennicott Ave Ste a
Arlington Heights, IL 60004-7815

Mailing address

3414A N Kennicott Avenue
Arlington, IL 60004-5905
Phone (847) 240-2211

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
I20040228000297 IL Practitioner - Clinical Psychologist 8022905702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3601 Algonquin Rd
Suite 714
Rolling Meadows, IL 60008-3111
Phone (847) 826-5881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-005997ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jo Wolthusen, PSYD PC Clinical CurrentSince Apr 8, 2024 Accepting new patients

Locations

3601 Algonquin Rd
Ste 714
Rolling Meadows, IL 60008
Phone (312) 409-1701

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1235209214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414A N KENNICOTT AVENUE",
            "city": "ARLINGTON",
            "state": "IL",
            "postal_code": "600045905",
            "telephone_number": "847-240-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 N KENNICOTT AVE STE A",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047815",
            "telephone_number": "847-240-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTHUSEN",
        "first_name": "JOSETTE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.