Active NPI
Rene Pichler-Mowry, PHD., HSPP
- Clinical Psychologist
- Hines, IL
National Provider Identifier
1386741015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20042102A
- Practice address
- 5000 S. 5TH Ave (Psychology 116B)
Hines, IL 60141-5000 - Phone
- (708) 202-8387
- NPI assigned
- Sep 17, 2006
- 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 | 20042102A | IN | Primary |
Addresses
Primary practice location
5000 S. 5TH Ave (Psychology 116B)
Hines, IL 60141-5000
Mailing address
5000 S. 5TH Ave (Psychology 116B)
Hines, IL 60141-5000
Phone (708) 202-8387
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000494543 | Other | IN | ANTHEM BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20042102A | IN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197331200000",
"number": "1386741015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 S. 5TH AVE (PSYCHOLOGY 116B)",
"city": "HINES",
"state": "IL",
"postal_code": "601415000",
"telephone_number": "708-202-8387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 S. 5TH AVE (PSYCHOLOGY 116B)",
"city": "HINES",
"state": "IL",
"postal_code": "601415000",
"telephone_number": "708-202-8387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICHLER-MOWRY",
"first_name": "RENE",
"credential": "PHD., HSPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-17",
"last_updated": "2007-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20042102A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000494543",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.