Spectrum Psychologial Services, P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-005733 Issued in IL

Legal business name

SPECTRUM PSYCHOLOGIAL SERVICES, P.C.

Practice address

1751 S Naperville Rd
Suite 207
Wheaton, IL 60189-5896

Phone

(630) 774-8316

NPI assigned

Jan 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Asif Ali Khan, PSY.D.

Title

President

Phone

(630) 774-8316

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1316218688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 S NAPERVILLE RD",
            "address_2": "SUITE 207",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895896",
            "telephone_number": "630-774-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 S NAPERVILLE RD",
            "address_2": "SUITE 207",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895896",
            "telephone_number": "630-774-8316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM PSYCHOLOGIAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ASIF",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-774-8316",
        "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": "071-005733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.