Individual provider Active NPI

Erin M. Odonohue, PSY.D.

  • Clinical Psychologist
  • Long Grove, IL
National Provider Identifier
1245569268
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.007909 Issued in IL
Practice address
4160 RFD Ste 307
Long Grove, IL 60047-9586
Phone
(630) 235-5876
NPI assigned
Dec 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.007909 IL Primary
Professional Counselor 101YP2500X 178.006421 IL

Addresses

Primary practice location

4160 RFD Ste 307
Long Grove, IL 60047-9586

Mailing address

4160 RFD Ste 307
Long Grove, IL 60047-9586
Phone (630) 235-5876

Other practice location 1

13011 S 104th Ave Ste 200
Palos Park, IL 60464-1500
Phone (170) 844-8330

Other names 1

  • Dr. Erin M. Omalley Former name

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
178.006421ILMDProfessional Counselor
071.007909ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
O'Donohue Partners LLC Clinical Past 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": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1245569268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 RFD STE 307",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600479586",
            "telephone_number": "630-235-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 RFD STE 307",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600479586",
            "telephone_number": "630-235-5876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13011 S 104th Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Palos Park",
            "state": "IL",
            "postal_code": "604641500",
            "country_code": "US",
            "telephone_number": "170-844-8330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODONOHUE",
        "first_name": "ERIN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-22",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007909",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.006421",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "OMALLEY",
            "middle_name": "M.",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.