Active NPI
Anna Matyja
- Clinical Psychologist
- North Chicago, IL
National Provider Identifier
1255789285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.009390
- Practice address
- 3471 Green Bay Road
North Chicago, IL 60064 - Phone
- (847) 473-4357
- NPI assigned
- May 31, 2016
- 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 | 071.009390 | IL | Primary |
Addresses
Primary practice location
3471 Green Bay Road
North Chicago, IL 60064
Mailing address
228 E Lake St
Addison, IL 60101-2889
Phone (224) 578-3709
Other practice location 1
228 E Lake St
Addison, IL 60101-2889
Phone (224) 578-3709
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3471 Green Bay Rd
North Chicago, IL 60064-3090
Phone (847) 578-8442
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.009390 | IL | MD | Clinical Psychologist |
Interoperability endpoints
- anna.matyja.1@3569.direct.athenahealth.com
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.
-
- Durable Medical Equipment & Medical Supplies
- North Chicago, IL
- NPI 1982894911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715731200000",
"number": "1255789285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 E LAKE ST",
"city": "ADDISON",
"state": "IL",
"postal_code": "601012889",
"telephone_number": "224-578-3709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3471 GREEN BAY ROAD",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "60064",
"telephone_number": "847-473-4357"
}
],
"practiceLocations": [
{
"address_1": "228 E Lake St",
"address_purpose": "LOCATION",
"city": "Addison",
"state": "IL",
"postal_code": "601012889",
"country_code": "US",
"telephone_number": "224-578-3709",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATYJA",
"first_name": "ANNA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-31",
"last_updated": "2024-05-15",
"certification_date": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.009390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.