Individual provider Active NPI

Michael E. Stone, PSY.D.

  • Clinical Psychologist
  • Skokie, IL
National Provider Identifier
1295744480
Registry record updated Aug 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071002933 Issued in IL
Practice address
5250 Old Orchard Rd
Ste. 300
Skokie, IL 60077-4460
Phone
(847) 966-0166
Fax
(847) 534-7630
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2016

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 071002933 IL Primary

Addresses

Primary practice location

5250 Old Orchard Rd
Ste. 300
Skokie, IL 60077-4460

Mailing address

5250 Old Orchard Rd
Ste. 300
Skokie, IL 60077-4460
Phone (847) 966-0166

Other identifiers 1

IdentifierTypeStateIssuer
0001672830OtherILBLUE 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
I20101025001283 IL Practitioner - Clinical Psychologist 9436342219 Practice locations: Skokie, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1295744480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 OLD ORCHARD RD",
            "address_2": "STE. 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774460",
            "telephone_number": "847-966-0166",
            "fax_number": "224-534-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 OLD ORCHARD RD",
            "address_2": "STE. 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774460",
            "telephone_number": "847-966-0166",
            "fax_number": "847-534-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "MICHAEL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071002933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001672830",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.