Organization Active NPI

Brett Fry, Psy.D., P.C.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1306116074
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071006942 Issued in IL
Legal business name
BRETT FRY, PSY.D., P.C.
Practice address
405 N Wabash Ave
Suite 1815
Chicago, IL 60611-5661
Phone
(773) 573-3612
NPI assigned
Jan 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Dr. Brett Fry, PSY.D.
Title
President
Phone
(773) 573-3612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 071006942 IL Primary

Addresses

Primary practice location

405 N Wabash Ave
Suite 1815
Chicago, IL 60611-5661

Mailing address

405 N Wabash Ave
Suite 1815
Chicago, IL 60611-5661
Phone (773) 573-3612

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1306116074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE",
            "address_2": "SUITE 1815",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115661",
            "telephone_number": "773-573-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE",
            "address_2": "SUITE 1815",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115661",
            "telephone_number": "773-573-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETT FRY, PSY.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-573-3612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.