Anita Kay McGruder-Johnson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Practice address

18 Strauss LN
Olympia Fields, IL 60461-1622

Phone

(708) 712-8197

Fax

(708) 429-2780

NPI assigned

Dec 11, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Oak Forest Psychological Service

  • Clinical Psychologist
  • Countryside, IL
  • NPI 1265487060
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1417017138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 STRAUSS LN",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611622",
            "telephone_number": "708-712-8197",
            "fax_number": "708-429-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 STRAUSS LN",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611622",
            "telephone_number": "708-712-8197",
            "fax_number": "708-429-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRUDER-JOHNSON",
        "first_name": "ANITA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard K MC Nair, M.D.
• Michele McCallum
• Shalese McClain
• Daniel P McCormick, M.D.
• James V McGarry, M.D.
• Ciara Dominique McNutt, PTA
• MD Orthotic and Prosthetic Laboratory, Inc.
• Me in the Making Wellness
• David Mehl, M.D.
• Ankeeta Mehta, D.O.

• Clinical Psychologist in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.