Individual provider Active NPI

Priya Badhwar, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1356869747
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071011158 Issued in IL
Practice address
333 N Michigan Ave Ste 2400
Chicago, IL 60601-4040
Phone
(773) 609-0361
Fax
(312) 896-5595
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 071011158 IL Primary

Addresses

Primary practice location

333 N Michigan Ave Ste 2400
Chicago, IL 60601-4040

Mailing address

1200 W Monroe St Apt 505
Chicago, IL 60607-2553
Phone (734) 552-7376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 11, 2024 through Dec 11, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071011158ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1356869747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W MONROE ST APT 505",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072553",
            "telephone_number": "734-552-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014040",
            "telephone_number": "773-609-0361",
            "fax_number": "312-896-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADHWAR",
        "first_name": "PRIYA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071011158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.