Individual provider Active NPI

Rashid A Raja, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1386705572
Registry record updated Sep 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.007541 Issued in IL
Practice address
1300 W Belmont Ave
Suite#504
Chicago, IL 60657-3200
Phone
(800) 994-6602
Fax
(800) 994-6602
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2020

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 071.007541 IL Primary

Addresses

Primary practice location

1300 W Belmont Ave
Suite#504
Chicago, IL 60657-3200

Mailing address

9217 Montgomery Dr
Orland Park, IL 60462-6506
Phone (800) 994-6602

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
I20090304000602 IL Practitioner - Clinical Psychologist 3173689866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1300 W Belmont Ave
Suite 504
Chicago, IL 60657-3242
Phone 8009946602101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.007541ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Behavioral Health, Inc. Clinical CurrentSince Oct 21, 2010 Accepting new patients
Marlin C Hoover PHD PC Clinical Past Accepting new patients

Locations

1300 W Belmont Ave
Ste 504
Chicago, IL 60657
Phone (800) 994-6602

1440 W Taylor St
Chicago, IL 60607
Phone (612) 263-9334

Organizations & group practices 2

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599264000000",
    "number": "1386705572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9217 MONTGOMERY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626506",
            "telephone_number": "800-994-6602",
            "fax_number": "800-994-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE",
            "address_2": "SUITE#504",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "800-994-6602",
            "fax_number": "800-994-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJA",
        "first_name": "RASHID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-09-05",
        "certification_date": "2020-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.