Active NPI
Diane M Herbstman Welbel PSYD LLC
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1285182121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071008625
- 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
- Last updated
- Sep 20, 2016
- Organization subpart
- No
NPPES NPI Registry
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
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 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 DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Clinical Psychologist
- Chicago, IL
- NPI 1609924232
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.