NPIMap

Organization Active NPI

Psychological Associates of Central Illinois LTD

  • Psychiatry Physician
  • Springfield, IL
National Provider Identifier
1376698050
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHOLOGICAL ASSOCIATES OF CENTRAL ILLINOIS LTD
Practice address
1124 South Sixth Street
Springfield, IL 62703-0406
Phone
(217) 523-3143
Fax
(217) 523-7695
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Cathy M Tomlin
Title
Office Manager
Phone
(217) 523-3143

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X IL
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X IL
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X IL Primary

Addresses

Primary practice location

1124 South Sixth Street
Springfield, IL 62703-0406

Mailing address

1124 South Sixth Street
Springfield, IL 62703-0406
Phone (217) 523-3143

Other names 1

  • Psychiatric Associates of Central Illinois Ltd Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040914000634 IL Part B Supplier - Clinic/Group Practice 1355318825 Receives reassigned benefits from 8 practitioners
Practice locations: Nauvoo, IL; Springfield, IL

National Provider Directory

National Provider Directory

Locations

5240 6th Street Frontage Rd E
Springfield, IL 62703
Phone (217) 523-3143

1124 S 6th St
Springfield, IL 62703
Phone (217) 523-3143

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1376698050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 SOUTH SIXTH STREET",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627030406",
            "telephone_number": "217-523-3143",
            "fax_number": "217-523-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 SOUTH SIXTH STREET",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627030406",
            "telephone_number": "217-523-3143",
            "fax_number": "217-523-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL ASSOCIATES OF CENTRAL ILLINOIS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "TOMLIN",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "217-523-3143"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Associates of Central Illinois Ltd",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.