Aysha Azimuddin

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071.011235 Issued in IL

Practice address

1602 W Colonial Pkwy Ste 200
Inverness, IL 60067-1215

Phone

(847) 349-0163

NPI assigned

Jun 9, 2015

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Serenity Counseling and Wellness

  • Group Psychotherapy Psychologist
  • Inverness, IL
  • NPI 1164009338
  NPD

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767225600000",
    "number": "1366822983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 W COLONIAL PKWY STE 200",
            "address_2": "SUITE 200",
            "city": "INVERNESS",
            "state": "IL",
            "postal_code": "600671215",
            "telephone_number": "847-364-0163",
            "fax_number": "847-984-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W COLONIAL PKWY STE 200",
            "city": "INVERNESS",
            "state": "IL",
            "postal_code": "600671215",
            "telephone_number": "847-349-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIMUDDIN",
        "first_name": "AYSHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2026-01-01",
        "certification_date": "2026-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.011235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Inverness, IL
• Providers in Inverness, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 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.