Active NPI
Douglas Scott Medgyesi, PSY.D.
- Psychologist
- Chicago, IL
National Provider Identifier
1346024593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071.011010
- Practice address
- 1509 W Berwyn Ave Ste 205
Chicago, IL 60640-8059 - Phone
- (773) 207-2158
- NPI assigned
- Aug 21, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071.011010 | IL | Primary |
Addresses
Primary practice location
1509 W Berwyn Ave Ste 205
Chicago, IL 60640-8059
Mailing address
4524 N Malden St Apt 118
Chicago, IL 60640-5578
Phone (913) 481-7522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.011010 | IL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1346024593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4524 N MALDEN ST APT 118",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405578",
"telephone_number": "913-481-7522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1509 W BERWYN AVE STE 205",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606408059",
"telephone_number": "773-207-2158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDGYESI",
"first_name": "DOUGLAS",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-21",
"last_updated": "2023-08-21",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071.011010",
"primary": true
}
],
"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 Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.