Active NPI
Stephen C Withrow, PSYD
- Clinical Psychologist
- Sycamore, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-007269
- Practice address
- 1850 Gateway Dr
Sycamore, IL 60178-3192 - Phone
- (815) 758-8671
- Fax
- (815) 758-5610
- NPI assigned
- Aug 14, 2006
- Last updated
- Nov 4, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180-004243 | IL | |
| Clinical Psychologist | 103TC0700X | 071-007269 | IL | Primary |
Addresses
Primary practice location
1850 Gateway Dr
Sycamore, IL 60178-3192
Mailing address
1850 Gateway Dr
Sycamore, IL 60178-3192
Phone (815) 758-8671
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180004243 | Other | IL | LICENSE |
| 071007269 | Other | IL | LICENSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1850 Gateway Dr
Sycamore, IL 60178-3192
Phone (630) 232-0280
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.63 of 100
- Quality
- 88.47
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-004243 | IL | MD | Professional Counselor |
| 071-007269 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Current | Accepting new patients | |
| Central Dupage Physician Group | Current | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521
224 E Railroad St
Sandwich, IL 60548
Phone (815) 786-7150
1850 Gateway Dr
Sycamore, IL 60178
Phone (815) 217-3252
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Northwestern Medicine Regional Medical Group
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
-
dba Northwestern Medicine Regional Medical Group
- Orthopaedic Surgery Physician
- Geneva, IL
- NPI 1780012344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320364800000",
"number": "1447263041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1850 GATEWAY DR",
"city": "SYCAMORE",
"state": "IL",
"postal_code": "601783192",
"telephone_number": "815-758-8671",
"fax_number": "815-758-5610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 GATEWAY DR",
"city": "SYCAMORE",
"state": "IL",
"postal_code": "601783192",
"telephone_number": "815-758-8671",
"fax_number": "815-758-5610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITHROW",
"first_name": "STEPHEN",
"middle_name": "C",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2011-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-004243",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-007269",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "180004243",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "071007269",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sycamore, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.