Active NPI
Carroll A Cradock, PH.D.
- Clinical Child & Adolescent Psychologist
- Chicago, IL
National Provider Identifier
1316085954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- Practice address
- 411 S Sangamon St
Suite 2a
Chicago, IL 60607-3547 - Phone
- (312) 243-7441
- NPI assigned
- Feb 4, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | Primary | ||
| Clinical Psychologist | 103TC0700X | IL |
Addresses
Primary practice location
411 S Sangamon St
Suite 2a
Chicago, IL 60607-3547
Mailing address
411 S Sangamon St
Suite 2a
Chicago, IL 60607-3547
Phone (312) 243-7441
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190117002687 | IL | Practitioner - Clinical Psychologist | 0840536454 | Practice locations: Chicago, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
411 S Sangamon St
Apt 2a
Chicago, IL 60607-3537
Phone (312) 243-7441
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-002231 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1316085954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 S SANGAMON ST",
"address_2": "SUITE 2A",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606073547",
"telephone_number": "312-243-7441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 S SANGAMON ST",
"address_2": "SUITE 2A",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606073547",
"telephone_number": "312-243-7441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRADOCK",
"first_name": "CARROLL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-04",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": null,
"primary": false
}
],
"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 Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.