Individual provider Active NPI

Peter Reiner, PHD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1285169094
Registry record updated Apr 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071003833 Issued in IL
Practice address
405 N Wabash Ave
Suite 4912
Chicago, IL 60611-3591
Phone
(312) 822-7277
NPI assigned
Apr 30, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071003833 IL Primary
Marriage & Family Therapist 106H00000X 166000417 IL

Addresses

Primary practice location

405 N Wabash Ave
Suite 4912
Chicago, IL 60611-3591

Mailing address

405 N Wabash Ave
Suite 4912
Chicago, IL 60611-3591
Phone (312) 822-7277

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071003833ILMDClinical Psychologist
166000417ILMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1493510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493510400000",
    "number": "1285169094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE",
            "address_2": "SUITE 4912",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113591",
            "telephone_number": "312-822-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE",
            "address_2": "SUITE 4912",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113591",
            "telephone_number": "312-822-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINER",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-30",
        "last_updated": "2017-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071003833",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166000417",
            "primary": false
        }
    ],
    "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 Apr 30, 2017; 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.