Psychology Professionals

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007039 Issued in IL

Legal business name

PSYCHOLOGY PROFESSIONALS

Practice address

9010 Reserve Dr
Willow Springs, IL 60480-1183

Phone

(708) 268-4159

Fax

(630) 455-0553

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jenny T Ebeid, PSYDNPI 1710998679

Title

President

Phone

(708) 268-4159

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jenny T Ebeid, PSYD

  • Clinical Psychologist
  • Naperville, IL
  • NPI 1710998679
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1245313071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9010 RESERVE DR",
            "city": "WILLOW SPRINGS",
            "state": "IL",
            "postal_code": "604801183",
            "telephone_number": "708-268-4159",
            "fax_number": "630-455-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9010 RESERVE DR",
            "city": "WILLOW SPRINGS",
            "state": "IL",
            "postal_code": "604801183",
            "telephone_number": "708-268-4159",
            "fax_number": "630-455-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "EBEID",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-268-4159",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rayna Murphy
• Michael Joseph Muszynski, M.D. MPH
• Manfred William Neumann, DDS
• O'Connor Foundation (NextSteps of O'Connor Foundation)
• PSHC, Inc. (Young at Heart)
• Agnieszka Rabrich, D.C.
• Ralph Solomon MD SC
• Bridgette Ratcliffe, LPC
• Morgan Phenix Rice, DPT
• Exequiel Rommel Rosaldo, PT, DPT

• Clinical Psychologist in Willow Springs, IL
• Providers in Willow Springs, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.