Individual provider Active NPI

Michael J Gainer, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1396962528
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
5015 N Paulina St
Ste. 310
Chicago, IL 60640-2756
Phone
(773) 271-2004
Fax
(773) 271-0924
NPI assigned
Apr 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

5015 N Paulina St
Ste. 310
Chicago, IL 60640-2756

Mailing address

5015 N Paulina St
Ste. 310
Chicago, IL 60640-2756
Phone (773) 271-2004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396962528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 N PAULINA ST",
            "address_2": "STE. 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402756",
            "telephone_number": "773-271-2004",
            "fax_number": "773-271-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 N PAULINA ST",
            "address_2": "STE. 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402756",
            "telephone_number": "773-271-2004",
            "fax_number": "773-271-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.