Individual provider Active NPI

Karlie Mirabelli, PHD, LCP

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1376334151
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.011446 Issued in IL
Practice address
1011 W Wellington Ave Ste 210
Chicago, IL 60657-7187
Phone
(312) 384-1940
NPI assigned
May 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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 071.011446 IL Primary

Addresses

Primary practice location

1011 W Wellington Ave Ste 210
Chicago, IL 60657-7187

Mailing address

1011 W Wellington Ave Ste 210
Chicago, IL 60657-7187
Phone (312) 766-0941

Other practice location 1

747 N La Salle Dr Ste 700
Chicago, IL 60654-5089
Phone (312) 766-0941

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250801002415 IL Practitioner - Clinical Psychologist 2264940121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. David Rakofsky PCGroup PAC ID 6103001797, 10 clinicians

Practice addresses (Care Compare)

1011 W Wellington Ave
Suite 210
Chicago, IL 60657-7187
Phone (312) 384-1940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.011446ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. David Rakofsky PC CurrentSince Jun 20, 2025 Accepting new patients

Locations

747 N La Salle Dr
Ste 700
Chicago, IL 60654

1011 W Wellington Ave
Ste 210
Chicago, IL 60657
Phone (312) 682-0958

666 Dundee Rd
Ste 706
Northbrook, IL 60062
Phone (312) 809-6911

1950 N Stemmons Fwy
Ste 5010
Dallas, TX 75207

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1376334151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W WELLINGTON AVE STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577187",
            "telephone_number": "312-766-0941",
            "fax_number": "773-423-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W WELLINGTON AVE STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577187",
            "telephone_number": "312-384-1940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 N La Salle Dr Ste 700",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606545089",
            "country_code": "US",
            "telephone_number": "312-766-0941",
            "fax_number": "773-423-8444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRABELLI",
        "first_name": "KARLIE",
        "name_prefix": "Dr.",
        "credential": "PHD, LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-13",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.011446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.