Active NPI
Rachel Sophia Port, PSY.D.
- Clinical Psychologist
- Evanston, IL
National Provider Identifier
1427204932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.008035
- Practice address
- 618 Library Place
Evanston, IL 60201 - Phone
- (847) 733-4300
- NPI assigned
- Aug 15, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.008035 | IL | Primary |
Addresses
Primary practice location
618 Library Place
Evanston, IL 60201
Mailing address
1111 Golfview Rd
Glenview, IL 60025-3119
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 |
|---|---|---|---|
| 071.008035 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393545600000",
"number": "1427204932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 GOLFVIEW RD",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600253119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 LIBRARY PLACE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "60201",
"telephone_number": "847-733-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORT",
"first_name": "RACHEL",
"middle_name": "SOPHIA",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-15",
"last_updated": "2014-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.008035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.