Individual provider Active NPI

Caitlin Grace Williams, PSY.D., LCP

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1447770060
Registry record updated Jun 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.008859 Issued in IL
Practice address
641 W 63Rd St
Chicago, IL 60621-2032
Phone
(773) 388-1600
Fax
(773) 783-8197
NPI assigned
Jun 24, 2017
Last updated
Jun 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.008859 IL Primary

Addresses

Primary practice location

641 W 63Rd St
Chicago, IL 60621-2032

Mailing address

77 W Huron St Apt 1511
Chicago, IL 60654-5325
Phone (608) 658-1095

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
I20170823003304 IL Practitioner - Clinical Psychologist 4880966902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Sinai Community FoundationGroup PAC ID 5991600405, 247 clinicians

Practice addresses (Care Compare)

2653 W Ogden Ave
FL 3 Suite a
Chicago, IL 60608-1647
Phone (773) 257-6672

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.008859ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center Current Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Howard Brown Health Center CurrentSince Jul 4, 2017 Accepting new patients
Howard Brown Health Center CurrentSince Jul 4, 2017 Accepting new patients
Mount Sinai Community Foundation CurrentSince Feb 1, 2023 Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

2653 W Ogden Ave
Fl 3
Chicago, IL 60608
Phone (773) 257-6701

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

641 W 63rd St
Chicago, IL 60621
Phone (312) 413-4070

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1498262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498262400000",
    "number": "1447770060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W HURON ST APT 1511",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545325",
            "telephone_number": "608-658-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606212032",
            "telephone_number": "773-388-1600",
            "fax_number": "773-783-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CAITLIN",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-24",
        "last_updated": "2017-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.