Active NPI
Kimberly Swiss, PSYD
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1306236005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 71008882
- Practice address
- 333 N Michigan Ave Ste 614
Chicago, IL 60601-3938 - Phone
- (773) 983-8478
- NPI assigned
- Feb 2, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 71008882 | IL | Primary |
Addresses
Primary practice location
333 N Michigan Ave Ste 614
Chicago, IL 60601-3938
Mailing address
800 Main St
Ste 210
Antioch, IL 60002-1578
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 24, 2024 through Apr 24, 2028
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": "1422835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556323200000",
"number": "1306236005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 MAIN ST",
"address_2": "STE 210",
"city": "ANTIOCH",
"state": "IL",
"postal_code": "600021578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N MICHIGAN AVE STE 614",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606013938",
"telephone_number": "773-983-8478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWISS",
"first_name": "KIMBERLY",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-02",
"last_updated": "2019-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "71008882",
"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 Apr 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.