Organization Active NPI

Diane M Herbstman Welbel PSYD LLC

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1285182121
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008625 Issued in IL
Legal business name
DIANE M HERBSTMAN WELBEL PSYD LLC
Practice address
3139 N Lincoln Ave
Suite 203
Chicago, IL 60657-3114
Phone
(847) 571-7726
NPI assigned
Sep 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Authorized official

Name
Dr. Diane M Welbel, PSY.D.
Title
Clinical Psychologist
Phone
(847) 571-7726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 071008625 IL Primary

Addresses

Primary practice location

3139 N Lincoln Ave
Suite 203
Chicago, IL 60657-3114

Mailing address

1412 W Wrightwood Ave
Unit G
Chicago, IL 60614-1195
Phone (847) 571-7726

National Provider Directory

National Provider Directory

Locations

3139 N Lincoln Ave
Ste 203
Chicago, IL 60657
Phone (312) 409-4701

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1285182121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 W WRIGHTWOOD AVE",
            "address_2": "UNIT G",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141195",
            "telephone_number": "847-571-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3139 N LINCOLN AVE",
            "address_2": "SUITE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573114",
            "telephone_number": "847-571-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANE M HERBSTMAN WELBEL PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "WELBEL",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "847-571-7726",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008625",
            "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 Sep 20, 2016; 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.