Individual provider Active NPI

Sharon Coleman Weems, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1255722112
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071006437 Issued in IL
Practice address
4511 S Forrestville Ave
Chicago, IL 60653-3424
Phone
(773) 354-1719
NPI assigned
Feb 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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 071006437 IL Primary

Addresses

Primary practice location

4511 S Forrestville Ave
Chicago, IL 60653-3424

Mailing address

4511 S Forrestville Ave
Chicago, IL 60653-3424
Phone (773) 354-1719

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
071006437ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1255722112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 S FORRESTVILLE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533424",
            "telephone_number": "773-354-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 S FORRESTVILLE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533424",
            "telephone_number": "773-354-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEMS",
        "first_name": "SHARON",
        "middle_name": "COLEMAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-13",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.