Individual provider Active NPI

Katherine Ruth Pierson Fruhauff, PSY.D.

  • Clinical Psychologist
  • Evanston, IL
National Provider Identifier
1285804757
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007441 Issued in IL
Practice address
2530 Crawford Ave Ste 104
Evanston, IL 60201-4954
Phone
(224) 408-0019
Fax
(855) 217-0165
NPI assigned
Mar 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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 071007441 IL Primary

Addresses

Primary practice location

2530 Crawford Ave Ste 104
Evanston, IL 60201-4954

Mailing address

2530 Crawford Ave Ste 104
Evanston, IL 60201-4954
Phone (224) 408-0019

Other names 1

  • Dr. Katie Fruhauff Other name

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
I20090507000597 IL Practitioner - Clinical Psychologist 7719035336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Katherine Fruhauff PSYD IncGroup PAC ID 4981945615, 2 clinicians

Practice addresses (Care Compare)

2530 Crawford Ave
Suite 210
Evanston, IL 60201-4959
Phone (224) 202-7616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071007441ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Katherine Fruhauff, PSYD, Inc. CurrentSince Jan 7, 2016 Accepting new patients
Samaritan Interfaith Counseling Center Inc. Clinical PastSince Jul 2, 2012 Accepting new patients

Locations

2530 Crawford Ave
Ste 210
Evanston, IL 60201
Phone (224) 202-7616

2530 Crawford Ave
Ste 104
Evanston, IL 60201
Phone (224) 408-0019

990 Grove St
Ste 501
Evanston, IL 60201

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1285804757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE STE 104",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014954",
            "telephone_number": "224-408-0019",
            "fax_number": "855-217-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE STE 104",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014954",
            "telephone_number": "224-408-0019",
            "fax_number": "855-217-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUHAUFF",
        "first_name": "KATHERINE",
        "middle_name": "RUTH PIERSON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "FRUHAUFF",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.