Individual provider Active NPI

Colleen Cira, PSYD

  • Clinical Psychologist
  • Evanston, IL
National Provider Identifier
1346568714
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-007895 Issued in IL
Practice address
800 Austin St
East Tower, Suite 352
Evanston, IL 60202-3439
Phone
(847) 329-9210
Fax
(708) 681-9280
NPI assigned
May 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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 071-007895 IL Primary

Addresses

Primary practice location

800 Austin St
East Tower, Suite 352
Evanston, IL 60202-3439

Mailing address

9933 Lawler Ave
Suite 338a
Skokie, IL 60077-3703
Phone (847) 329-9210

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
I20100812000301 IL Practitioner - Clinical Psychologist 4183758154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cira Center for Behavioral Health PCGroup PAC ID 3870879190, 5 clinicians

Practice addresses (Care Compare)

1011 Lake St
Suite 307
Oak Park, IL 60301-1138
Phone (872) 395-8091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-007895ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cira Center for Behavioral Health PC CurrentSince Mar 20, 2017 Accepting new patients
Gersten & Associates Past Accepting new patients

Locations

155 N Michigan Ave
Ste 450
Chicago, IL 60601
Phone (872) 395-8091

1011 Lake St
Ste 307
Oak Park, IL 60301
Phone (872) 395-8091

Organizations & group practices 2

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": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1346568714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE",
            "address_2": "SUITE 338A",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773703",
            "telephone_number": "847-329-9210",
            "fax_number": "708-681-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST",
            "address_2": "EAST TOWER, SUITE 352",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023439",
            "telephone_number": "847-329-9210",
            "fax_number": "708-681-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRA",
        "first_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-007895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.