Parkside Psychological Services, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.007555 Issued in IL

Legal business name

PARKSIDE PSYCHOLOGICAL SERVICES, LLC

Practice address

840 S Waukegan Rd Ste 203
Lake Forest, IL 60045-2619

Phone

(847) 420-5088

NPI assigned

Dec 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Paul Smiley, PSYD, ABPPNPI 1588861579

Title

Clinical Psychologist

Phone

(847) 420-5088

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

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

• Paul Smiley, PSY.D., ABCP

  • Clinical Psychologist
  • Lake Forest, IL
  • NPI 1588861579
  Medicare reassignment Care Compare group NPD Authorized official
• Maja Jakovljevic, PSYD

  • Clinical Psychologist
  • Northfield, IL
  • NPI 1811728322
  Medicare reassignment Care Compare group NPD
• Jill Sanderson-Davis, LCSW

  • Clinical Social Worker
  • Glenview, IL
  • NPI 1063664787
  Medicare reassignment Care Compare group NPD
• Sharon Song, PH.D.

  • Clinical Psychologist
  • Palatine, IL
  • NPI 1912983651
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1295100485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WAUKEGAN RD STE 203",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452619",
            "telephone_number": "847-420-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S WAUKEGAN RD STE 203",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452619",
            "telephone_number": "847-420-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "SMILEY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "847-420-5088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, ABPP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Palarz
• Paper Crane Counseling LLC
• Janine Pappageorge
• David Jeesoo Park, MD
• Ji-Weon Park, MD
• Laura Michelle Paschen, PTA
• Jenna Passolt, M.S. SLP
• Catherine Margaret Pastuovic, OTR/L, MSOT
• Amitkumar Rasik Patel, M.D.
• Gopi R. Patel, D.O

• Clinical Psychologist in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.