Individual provider Active NPI

Neha Patel, PSYD

  • Clinical Psychologist
  • Skokie, IL
National Provider Identifier
1417073321
Registry record updated Jan 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.006760 Issued in IL
Practice address
4905 Old Orchard Ctr Ste 521
Skokie, IL 60077-4736
Phone
(312) 545-6435
NPI assigned
Mar 22, 2007
Last updated
Jan 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2023

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 071.006760 IL Primary

Addresses

Primary practice location

4905 Old Orchard Ctr Ste 521
Skokie, IL 60077-4736

Mailing address

3015 Keystone Rd
Northbrook, IL 60062-5107
Phone (312) 545-6435

Other practice location 1

3015 Keystone Rd
Northbrook, IL 60062-5107
Phone (312) 545-6435

Other practice location 2

5250 Old Orchard Rd Ste 300
Skokie, IL 60077-4462
Phone (312) 545-6435

Other identifiers 1

IdentifierTypeStateIssuer
071.006760OtherILCLINICAL PSYCHOLOGIST

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
071.006760ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aasha Mental Health LLC CurrentSince Jan 8, 2023 Accepting new patients

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672531200000",
    "number": "1417073321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 KEYSTONE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625107",
            "telephone_number": "312-545-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD CTR STE 521",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774736",
            "telephone_number": "312-545-6435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 Keystone Rd",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600625107",
            "country_code": "US",
            "telephone_number": "312-545-6435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5250 Old Orchard Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600774462",
            "country_code": "US",
            "telephone_number": "312-545-6435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NEHA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2023-01-01",
        "certification_date": "2023-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.006760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGIST",
            "identifier": "071.006760",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 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.