Individual provider Active NPI

Katica Pasic, PSY. D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1346300050
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-004872 Issued in IL
Practice address
7714 N Eastlake Ter
Suite 1
Chicago, IL 60626-1304
Phone
(773) 761-0026
Fax
(312) 612-1479
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-004872 IL Primary

Addresses

Primary practice location

7714 N Eastlake Ter
Suite 1
Chicago, IL 60626-1304

Mailing address

7714 N Eastlake Ter
Suite 1
Chicago, IL 60626-1304
Phone (773) 761-0026

Other identifiers 2

IdentifierTypeStateIssuer
071004872MedicaidIL
071-004872OtherILSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040913000143 IL Practitioner - Clinical Psychologist 6406823202 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7714 N Eastlake Ter
Chicago, IL 60626-1304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-004872ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Davken Associates, P.C. Clinical PastSince May 1, 2016 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1346300050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7714 N EASTLAKE TER",
            "address_2": "SUITE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606261304",
            "telephone_number": "773-761-0026",
            "fax_number": "312-612-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7714 N EASTLAKE TER",
            "address_2": "SUITE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606261304",
            "telephone_number": "773-761-0026",
            "fax_number": "312-612-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASIC",
        "first_name": "KATICA",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-004872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071004872",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "071-004872",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.