Individual provider Active NPI

Khanh Ngoc Nghiem, PHD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1356214753
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009998 Issued in IL
Practice address
119 S Western Ave Unit 1
Chicago, IL 60612-4644
Phone
(352) 215-6351
NPI assigned
Sep 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 071009998 IL Primary

Addresses

Primary practice location

119 S Western Ave Unit 1
Chicago, IL 60612-4644

Mailing address

119 S Western Ave Unit 1
Chicago, IL 60612-4644

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071009998ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ponder Mental Wellness, PLLC CurrentSince Sep 1, 2025 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": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1356214753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S WESTERN AVE UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S WESTERN AVE UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124644",
            "telephone_number": "352-215-6351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGHIEM",
        "first_name": "KHANH",
        "middle_name": "NGOC",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-24",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009998",
            "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 Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.