Individual provider Active NPI

Patricia M Meaden, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1285642553
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-005338 Issued in IL
Practice address
180 N Michigan Ave
Suite 2403
Chicago, IL 60601-7401
Phone
(312) 920-0133
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-005338 IL Primary

Addresses

Primary practice location

180 N Michigan Ave
Suite 2403
Chicago, IL 60601-7401

Mailing address

217 16TH St
Wilmette, IL 60091-3226
Phone (847) 256-0943

Other identifiers 1

IdentifierTypeStateIssuer
0001622652OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031111000135 IL Practitioner - Clinical Psychologist 5395658884 Practice locations: Evanston, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1213 Mulford St
Apt 2E
Evanston, IL 60202-3267
Phone (847) 691-9537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-005338ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285642553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 16TH ST",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600913226",
            "telephone_number": "847-256-0943",
            "fax_number": "847-256-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 2403",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017401",
            "telephone_number": "312-920-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADEN",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001622652",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.