Individual provider Active NPI

Aoibheann Elizaveta Emmerson Sparrow, PSYD

  • Clinical Psychologist
  • Naperville, IL
National Provider Identifier
1235799073
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0000 Issued in IL
Practice address
2948 Artesian Rd Ste 112
Naperville, IL 60564-8559
Phone
(630) 428-7890
NPI assigned
Jun 14, 2019
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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 0000 IL Primary

Addresses

Primary practice location

2948 Artesian Rd Ste 112
Naperville, IL 60564-8559

Mailing address

2948 Artesian Rd # Suire112
Naperville, IL 60564-8558
Phone (630) 428-7890

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

State licenses

LicenseStateTypeSpecialty
0000ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. CurrentSince Mar 1, 2024 Accepting new patients
Edgewood Clinical Services, P.C. PastSince Mar 1, 2024 Accepting new patients

Locations

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

Organizations & group practices 2

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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1235799073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2948 ARTESIAN RD # SUIRE112",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648558",
            "telephone_number": "630-428-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2948 ARTESIAN RD STE 112",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648559",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARROW",
        "first_name": "AOIBHEANN",
        "middle_name": "ELIZAVETA EMMERSON",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2019-06-14",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "0000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.