Joseph Gerard Potaczek, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009763 Issued in IL

Practice address

77 W Washington St Ste 2110
Chicago, IL 60602-9703

Phone

(312) 637-8447

Fax

(312) 253-1433

NPI assigned

Mar 27, 2018

Last updated

Mar 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1356846745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2229 W CORTEZ ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223518",
            "telephone_number": "773-485-0515",
            "fax_number": "312-253-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W WASHINGTON ST STE 2110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606029703",
            "telephone_number": "312-637-8447",
            "fax_number": "312-253-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTACZEK",
        "first_name": "JOSEPH",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Posterity Men's Health, P.C.
• Bridgette Ladell Poston, MSW, LCSW
• Jason Poston
• Lindsay Poston, MD
• Zoe Postula, MS CCC-SLP
• Ismene Potakis, PA-C
• Nivedita Ravi Potapragada
• Edward John Potash, M.D.
• Steven R Potashnick, D.D.S.
• Lindsey Anne Pote, PHARM.D.

• 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 Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.