Individual provider Active NPI

Judith S. Tellerman, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1295717577
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
2020 N Lincoln Park W
38J
Chicago, IL 60614-4780
Phone
(773) 281-9034
Fax
(773) 281-9036
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 IL Primary

Addresses

Primary practice location

2020 N Lincoln Park W
38J
Chicago, IL 60614-4780

Mailing address

2020 N Lincoln Park W
38J
Chicago, IL 60614-4780
Phone (773) 281-9034

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
I20090605000300 IL Practitioner - Clinical Psychologist 1759431174 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2020 N Lincoln Park W
Apt 38J
Chicago, IL 60614-4734
Phone (773) 281-9034

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295717577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 N LINCOLN PARK W",
            "address_2": "38J",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144780",
            "telephone_number": "773-281-9034",
            "fax_number": "773-281-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 N LINCOLN PARK W",
            "address_2": "38J",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144780",
            "telephone_number": "773-281-9034",
            "fax_number": "773-281-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLERMAN",
        "first_name": "JUDITH",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.