Individual provider Active NPI

Brianna Werner

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1417599408
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-010365 Issued in IL
Practice address
325 S Paulina St
Chicago, IL 60612-3206
Phone
(312) 942-6476
NPI assigned
Oct 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X
Clinical Psychologist 103TC0700X 071-010365 IL Primary

Addresses

Primary practice location

325 S Paulina St
Chicago, IL 60612-3206

Mailing address

325 S Paulina St
Chicago, IL 60612-3206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201104000219 IL Practitioner - Clinical Psychologist 0941610802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Clinical CurrentSince Oct 2, 2020 Accepting new patients
Rush University Medical Center CurrentSince Oct 2, 2020 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1645 W Jackson Blvd
Ste 602
Chicago, IL 60612
Phone (312) 942-8387

325 S Paulina St
Chicago, IL 60612
Phone (312) 563-1535

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1417599408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123206",
            "telephone_number": "312-942-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "BRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-010365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.