NPIMap

Organization Active NPI

Shared Vision Psychological Services

Doing business as Shared Vision Psychological Services, dba Pediatric Psychology Assoc.

  • Clinical Psychologist
  • Oak Brook, IL
National Provider Identifier
1275738130
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SHARED VISION PSYCHOLOGICAL SERVICES
Doing business as
Shared Vision Psychological Services, dba Pediatric Psychology Assoc.
Practice address
1200 Harger Rd
#600
Oak Brook, IL 60523
Phone
(630) 571-5750
Fax
(630) 571-5751
NPI assigned
Jun 19, 2007
Last updated
Feb 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Authorized official

Name
Dr. Myra M. Lawrence, PSY.D.NPI 1073638375
Title
Ceo
Phone
(630) 571-1110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

1200 Harger Rd
#600
Oak Brook, IL 60523

Mailing address

1200 Harger Rd
#600
Oak Brook, IL 60523
Phone (630) 571-5750

Other names 1

  • Shared Vision Psychological Services, dba Pediatric Psychology Assoc. Doing business as

National Provider Directory

National Provider Directory

Locations

1200 Harger Rd
Ste 600
Oak Brook, IL 60523
Phone (630) 571-5750

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1275738130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HARGER RD",
            "address_2": "#600",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "60523",
            "telephone_number": "630-571-5750",
            "fax_number": "630-571-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HARGER RD",
            "address_2": "#600",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "60523",
            "telephone_number": "630-571-5750",
            "fax_number": "630-571-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARED VISION PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "MYRA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "630-571-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shared Vision Psychological Services, dba Pediatric Psychology Assoc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.