Active NPI
Lynnea Renae Vis, PSY.D.
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1366685513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810006182
- Practice address
- 901 W Gunnison St # 2E
Chicago, IL 60640-4210 - Phone
- (571) 442-4247
- NPI assigned
- Apr 16, 2009
- Last updated
- Feb 26, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810006182 | VA | Primary |
Addresses
Primary practice location
901 W Gunnison St # 2E
Chicago, IL 60640-4210
Mailing address
Mag-36
Unit 37131
Fpo, AP 96386-7131
Phone (571) 442-4247
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810006182 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740528000000",
"number": "1366685513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "MAG-36",
"address_2": "UNIT 37131",
"city": "FPO",
"state": "AP",
"postal_code": "963867131",
"telephone_number": "571-442-4247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 W GUNNISON ST # 2E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606404210",
"telephone_number": "571-442-4247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIS",
"first_name": "LYNNEA",
"middle_name": "RENAE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-16",
"last_updated": "2025-02-26",
"certification_date": "2025-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810006182",
"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 Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.