NPIMap

Organization Active NPI

Brian Timothy Madvig

  • Clinical Psychologist
  • Wheaton, IL
National Provider Identifier
1285641472
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-005079 Issued in IL
Legal business name
BRIAN TIMOTHY MADVIG
Practice address
1725 S Naperville Rd
Suite 207
Wheaton, IL 60187-8155
Phone
(630) 462-7005
Fax
(630) 462-7006
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Brian T. Madvig, PH.D.NPI 1467464792
Title
Owner
Phone
(630) 462-7005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 071-005079 IL Primary

Addresses

Primary practice location

1725 S Naperville Rd
Suite 207
Wheaton, IL 60187-8155

Mailing address

1725 S Naperville Rd
Suite 207
Wheaton, IL 60187-8155
Phone (630) 462-7005

Other names 1

  • Arbor Clinical Associates Doing business as

National Provider Directory

National Provider Directory

Locations

1725 S Naperville Rd
Ste 207
Wheaton, IL 60189
Phone (630) 462-7005

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1285641472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD",
            "address_2": "SUITE 207",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601878155",
            "telephone_number": "630-462-7005",
            "fax_number": "630-462-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD",
            "address_2": "SUITE 207",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601878155",
            "telephone_number": "630-462-7005",
            "fax_number": "630-462-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN TIMOTHY MADVIG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "MADVIG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-462-7005",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arbor Clinical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.