Active NPI
Amanda C Taylor, PHD
- Clinical Psychologist
- Hines, IL
National Provider Identifier
1245593433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071008346
- Practice address
- 5000 S 5TH Ave # 116B
Hines, IL 60141-3030 - Phone
- (708) 202-8387
- Fax
- (708) 202-5550
- NPI assigned
- Jun 21, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071008346 | IL | Primary |
Addresses
Primary practice location
5000 S 5TH Ave # 116B
Hines, IL 60141-3030
Mailing address
5000 S 5TH Ave # 116B
Hines, IL 60141-3030
Phone (708) 202-8387
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071008346 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340236800000",
"number": "1245593433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 S 5TH AVE # 116B",
"city": "HINES",
"state": "IL",
"postal_code": "601413030",
"telephone_number": "708-202-8387",
"fax_number": "708-202-5550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 S 5TH AVE # 116B",
"city": "HINES",
"state": "IL",
"postal_code": "601413030",
"telephone_number": "708-202-8387",
"fax_number": "708-202-5550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "AMANDA",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-21",
"last_updated": "2012-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071008346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.