NPIMap

Organization Active NPI

Oak Forest Psychological Service

  • Clinical Psychologist
  • Countryside, IL
National Provider Identifier
1326219510
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
OAK FOREST PSYCHOLOGICAL SERVICE
Practice address
6502 Joliet Rd
Countryside, IL 60525-4682
Phone
(708) 215-8400
Fax
(708) 215-8410
NPI assigned
Mar 17, 2008
Last updated
Feb 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Authorized official

Name
Karen Nekolny-SmithNPI 1760542484
Title
Clinical Coordinator
Phone
(708) 215-8400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Psychologist 103TC0700X NU Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

6502 Joliet Rd
Countryside, IL 60525-4682

Mailing address

6502 Joliet Rd
Floor 2
Countryside, IL 60525-4613
Phone (708) 215-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326001218 IL Part B Supplier - Clinic/Group Practice 6507762580 Receives reassigned benefits from 9 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winfield, IL; Zion, IL; Wheaton, IL; Stickney, IL; Robbins, IL; Kankakee, IL; Joliet, IL; Hazel Crest, IL…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Oak Forest Psychologic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1326219510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6502 JOLIET RD",
            "address_2": "FLOOR 2",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605254613",
            "telephone_number": "708-215-8400",
            "fax_number": "708-215-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6502 JOLIET RD",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605254682",
            "telephone_number": "708-215-8400",
            "fax_number": "708-215-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK FOREST PSYCHOLOGICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "NEKOLNY-SMITH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CLINICAL COORDINATOR",
        "authorized_official_telephone_number": "708-215-8400"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Countryside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.