Psychpromd LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PSYCHPROMD LLC

Practice address

1650 Moon Lake Blvd
Hoffman Estates, IL 60169-1010

Phone

(312) 599-1948

NPI assigned

Nov 30, 2024

Organization subpart

No

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

Authorized official

Name

Shaun WoodNPI 1568461788

Title

Owner

Phone

(312) 599-1948

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shaun P Wood, MD

  • Psychiatry Physician
  • Indianapolis, IN
  • NPI 1568461788

  IL

  Medicare reassignment NPD Authorized official
• Purvi S Patel, FNP

  • Family Nurse Practitioner
  • Rockford, IL
  • NPI 1881097244
  Medicare reassignment NPD

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

{
    "created_epoch": "1732924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732924800000",
    "number": "1346066883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 S ARLINGTON HEIGHTS RD STE 342",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 MOON LAKE BLVD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691010",
            "telephone_number": "312-599-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHPROMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-30",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-599-1948"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2024; 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.