Individual provider Active NPI

Kimberly Swiss, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1306236005
Registry record updated Apr 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
71008882 Issued in IL
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

Updated by the provider on Apr 27, 2019

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 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

Verify at the official NPI Registry.