Individual provider Active NPI

Robin L. Rundell, PSY.D

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1407150808
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.004420 Issued in IL
Practice address
307 North Michigan Avenue
Suite 2016
Chicago, IL 60601
Phone
(312) 915-0056
NPI assigned
Dec 29, 2010
Sex
Female
Sole proprietor
No

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

State licenses

LicenseStateTypeSpecialty
071.004420ILMDClinical Psychologist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.004420 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

307 North Michigan Avenue
Suite 2016
Chicago, IL 60601

Mailing address

307 North Michigan Avenue
Suite 2016
Chicago, IL 60601
Phone (312) 915-0056

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 29, 2010.

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1407150808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 NORTH MICHIGAN AVENUE",
            "address_2": "SUITE 2016",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60601",
            "telephone_number": "312-915-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 NORTH MICHIGAN AVENUE",
            "address_2": "SUITE 2016",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60601",
            "telephone_number": "312-915-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDELL",
        "first_name": "ROBIN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-29",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.004420",
            "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 Dec 29, 2010; 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.