Rachael Ellison, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009905 Issued in IL

Practice address

333 N Michigan Ave Ste 1801
Chicago, IL 60601-3984

Phone

(312) 345-0933

NPI assigned

Sep 27, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Goldstein Neuropsychologists PC

  • Clinical Neuropsychologist
  • Chicago, IL
  • NPI 1063568210
  Medicare reassignment NPD

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1265083422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE STE 1801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606013984",
            "telephone_number": "312-345-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "RACHAEL",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tierra Ellis
• Gabrielle Renee Ellison, LCPC
• Jana S. Ellison, MS, OTR/L
• Kelly Ann Ellison
• Latisha Ellison
• Shadon Michele Ellison, B.S.
• Sharon Ello, LCSW
• Alfred Raymond Ellsworth, DPT
• Brandon Lee Ellsworth, MD MSC
• De'Juan Ellsworth

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.