Active NPI
Shauna Rosenberg Freedman, PSY.D.
- Clinical Child & Adolescent Psychologist
- Chicago, IL
National Provider Identifier
1396093126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 071008949
- Practice address
- 1460 N Halsted St
Suite 503/504
Chicago, IL 60642-2605 - Phone
- (847) 686-0090
- Fax
- (847) 686-0090
- NPI assigned
- Aug 28, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 Child & Adolescent Psychologist | 103TC2200X | 071008949 | IL | Primary |
Addresses
Primary practice location
1460 N Halsted St
Suite 503/504
Chicago, IL 60642-2605
Mailing address
1460 N Halsted St
Suite 503/504
Chicago, IL 60642-2605
Phone (847) 686-0090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071008949 | IL | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422230400000",
"number": "1396093126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1460 N HALSTED ST",
"address_2": "SUITE 503/504",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606422605",
"telephone_number": "847-686-0090",
"fax_number": "847-686-0090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1460 N HALSTED ST",
"address_2": "SUITE 503/504",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606422605",
"telephone_number": "847-686-0090",
"fax_number": "847-686-0090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEDMAN",
"first_name": "SHAUNA",
"middle_name": "ROSENBERG",
"name_prefix": "Ms.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-28",
"last_updated": "2015-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "IL",
"license": "071008949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.