Peggy Wingo, PH.D.,LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-004959 Issued in IL

Practice address

1248 American Way
Libertyville, IL 60048-3936

Phone

(847) 691-7533

Fax

(224) 433-6998

NPI assigned

Jun 23, 2007

Last updated

Apr 26, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Loyola University of Chicago, Stritch School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peggy Wingo PH.D., LLC

  • Clinical Psychologist
  • Libertyville, IL
  • NPI 1649302050
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1182556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1326244625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1248 AMERICAN WAY",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483936",
            "telephone_number": "847-691-7533",
            "fax_number": "224-433-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 AMERICAN WAY",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483936",
            "telephone_number": "847-691-7533",
            "fax_number": "224-433-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGO",
        "first_name": "PEGGY",
        "name_prefix": "Dr.",
        "credential": "PH.D.,LLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-23",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-004959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.

Verify at the official NPI Registry.