Individual provider Active NPI

Linda Deming Lewis, PH.D

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1255452405
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071003631 Issued in IL
Practice address
180 N Michigan Ave
Suite 2222
Chicago, IL 60601-7401
Phone
(312) 360-1333
Fax
(312) 461-9586
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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 071003631 IL Primary

Addresses

Primary practice location

180 N Michigan Ave
Suite 2222
Chicago, IL 60601-7401

Mailing address

180 N Michigan Ave
Suite 2222
Chicago, IL 60601-7401
Phone (312) 360-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160909001277 IL Practitioner - Clinical Psychologist 9436445947 Practice locations: Evanston, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

321 Wesley Ave
Evanston, IL 60202-3234
Phone (312) 360-1333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071003631ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1255452405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 2222",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017401",
            "telephone_number": "312-360-1333",
            "fax_number": "312-461-9586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 2222",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017401",
            "telephone_number": "312-360-1333",
            "fax_number": "312-461-9586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "LINDA",
        "middle_name": "DEMING",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071003631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.