Individual provider Active NPI

Cynthia Ann Dopke, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1285692574
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-005926 Issued in IL
Practice address
233 E Erie St
601
Chicago, IL 60611-2926
Phone
(312) 649-0854
Fax
(312) 649-0882
NPI assigned
May 3, 2006
Last updated
Mar 29, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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 071-005926 IL Primary

Addresses

Primary practice location

233 E Erie St
601
Chicago, IL 60611-2926

Mailing address

233 E Erie St
Ste 601
Chicago, IL 60611-5934
Phone (312) 649-0854

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
I20120724000581 IL Practitioner - Clinical Psychologist 1850557596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

645 N Michigan Ave
Suite 500
Chicago, IL 60611-2881
Phone (312) 649-0854

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071-005926ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cynthia a. Dopke, PH.D., P.C. CurrentSince Mar 15, 2012 Accepting new patients

Locations

233 E Erie St
Ste 601
Chicago, IL 60611
Phone (312) 649-0854

645 N Michigan Ave
Ste 500
Chicago, IL 60611
Phone (312) 787-6173

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1285692574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 E ERIE ST",
            "address_2": "STE 601",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115934",
            "telephone_number": "312-649-0854",
            "fax_number": "312-649-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E ERIE ST",
            "address_2": "601",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112926",
            "telephone_number": "312-649-0854",
            "fax_number": "312-649-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOPKE",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.