Active NPI
Alison Rogers, PSY.D
- Psychologist
- Lake Villa, IL
National Provider Identifier
1417479676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071.009569
- Practice address
- 420 W. Grand Ave
Lake Villa, IL 60046 - Phone
- (847) 356-3322
- NPI assigned
- Jul 10, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071.009569 | IL | Primary |
Addresses
Primary practice location
420 W. Grand Ave
Lake Villa, IL 60046
Mailing address
311 Woodbine Rd
Cary, IL 60013-3050
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.009569 | IL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507507200000",
"number": "1417479676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 WOODBINE RD",
"city": "CARY",
"state": "IL",
"postal_code": "600133050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 W. GRAND AVE",
"city": "LAKE VILLA",
"state": "IL",
"postal_code": "60046",
"telephone_number": "847-356-3322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "ALISON",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-10",
"last_updated": "2017-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071.009569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Villa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.