Active NPI
Michelle Diane James, PH.D.
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1396977146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-005919
- Practice address
- 1871 N Clybourn Ave
Suite 224
Chicago, IL 60614-4947 - Phone
- (773) 913-2029
- Fax
- (847) 635-1764
- NPI assigned
- Aug 12, 2009
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071-005919 | IL | |
| Clinical Psychologist | 103TC0700X | 071-005919 | IL | Primary |
| Group Psychotherapy Psychologist | 103TP2701X | 071-005919 | IL |
Addresses
Primary practice location
1871 N Clybourn Ave
Suite 224
Chicago, IL 60614-4947
Mailing address
6727 S Oglesby Ave
# C1
Chicago, IL 60649-1315
Phone (773) 913-2029
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-005919 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250208000000",
"number": "1396977146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6727 S OGLESBY AVE",
"address_2": "# C1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606491315",
"telephone_number": "773-913-2029",
"fax_number": "847-635-1764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1871 N CLYBOURN AVE",
"address_2": "SUITE 224",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606144947",
"telephone_number": "773-913-2029",
"fax_number": "847-635-1764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "MICHELLE",
"middle_name": "DIANE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-12",
"last_updated": "2009-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071-005919",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-005919",
"primary": true
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "IL",
"license": "071-005919",
"primary": false
}
],
"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 Aug 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.