NPIMap

Organization Active NPI

Jaclyn Kamradt PHD, P.C.

  • Clinical Psychologist
  • New Lenox, IL
National Provider Identifier
1396450706
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
JACLYN KAMRADT PHD, P.C.
Practice address
2081 Calistoga Dr Ste 2N
New Lenox, IL 60451-4833
Phone
(708) 373-9440
NPI assigned
Jan 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Authorized official

Name
Dr. Jaclyn Kamradt, PHDNPI 1982335998
Title
Clinical Psychologist
Phone
(708) 373-9440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

2081 Calistoga Dr Ste 2N
New Lenox, IL 60451-4833

Mailing address

11545 Ashbury CT
Mokena, IL 60448-9490
Phone (708) 373-9440

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1396450706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11545 ASHBURY CT",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489490",
            "telephone_number": "708-373-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 CALISTOGA DR STE 2N",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604514833",
            "telephone_number": "708-373-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACLYN KAMRADT PHD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "KAMRADT",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "708-373-9440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.