Active NPI
Ivan Budisin, PH.D.
- Counseling Psychologist
- Chicago, IL
National Provider Identifier
1437447141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 071.008157
- Practice address
- 5001 N Ravenswood Ave
Ste 228
Chicago, IL 60640-2711 - Phone
- (847) 778-8371
- NPI assigned
- Jul 14, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 071.008157 | IL | Primary |
Addresses
Primary practice location
5001 N Ravenswood Ave
Ste 228
Chicago, IL 60640-2711
Mailing address
PO Box 31831
Chicago, IL 60631-0831
Phone (847) 778-8371
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.008157 | IL | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490313600000",
"number": "1437447141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31831",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606310831",
"telephone_number": "847-778-8371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 N RAVENSWOOD AVE",
"address_2": "STE 228",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606402711",
"telephone_number": "847-778-8371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUDISIN",
"first_name": "IVAN",
"name_prefix": "Mr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-14",
"last_updated": "2017-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "IL",
"license": "071.008157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.