Jeremy Luce, MA, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.0100007 Issued in IL

Practice address

2451 N Lincoln Ave Ste 206
Chicago, IL 60614-1509

Phone

(708) 320-9694

NPI assigned

Oct 7, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Old Oak Psychological Health Center, LLC

  • Adult Mental Health Clinic/Center
  • Mt Prospect, IL
  • NPI 1558923789
  NPD Authorized official

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1356744171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 N LINCOLN AVE STE 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141509",
            "telephone_number": "708-320-9694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 N LINCOLN AVE STE 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141509",
            "telephone_number": "708-320-9694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 W Lake St",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "IL",
            "postal_code": "601011101",
            "country_code": "US",
            "telephone_number": "630-221-4691 x4691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCE",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "MA, PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-07",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.0100007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "071.0100007",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lily Lucas, DPT
• Tranisha Lynette Lucas, FNP-BC
• Kaitlyn E Lucca, LCSW
• Katherine Lucchesi
• Tessa Lucchi, PSYD
• Madison Luce
• Dino Angelo Ruiz Lucena, RN
• Lucent Psychotherapy
• Kristin Rose Lucente, APN-CNP
• Laura Lucenti

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.