Amy Beth Wolok, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071008721 Issued in IL

Practice address

950 Lee St
212
Des Plaines, IL 60016-6532

Phone

(847) 486-4140

Fax

(847) 486-4145

NPI assigned

Dec 11, 2013

Last updated

Dec 11, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Amy Beth Given Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1235560590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 LEE ST",
            "address_2": "212",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166532",
            "telephone_number": "847-486-4140",
            "fax_number": "847-486-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 LEE ST",
            "address_2": "212",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166532",
            "telephone_number": "847-486-4140",
            "fax_number": "847-486-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLOK",
        "first_name": "AMY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071008721",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008721",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071008721",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "GIVEN",
            "middle_name": "BETH",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Psychologist in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.