Individual provider Active NPI

Lisa N Dworkin-Cantor

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1457684144
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071005338 Issued in IL
Practice address
3322 N Ashland Ave
Chicago, IL 60657-0195
Phone
(773) 472-8587
NPI assigned
Sep 11, 2009
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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 071005338 IL Primary

Addresses

Primary practice location

3322 N Ashland Ave
Chicago, IL 60657-0195

Mailing address

2521 N Bernard St
Chicago, IL 60647-1201

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Niquie Dworkin, Inc Current Accepting new patients
Niquie Dworkin, Inc Current Accepting new patients

Locations

3322 N Ashland Ave
Chicago, IL 60657
Phone (773) 472-8587

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1457684144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 N BERNARD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606570195",
            "telephone_number": "773-472-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWORKIN-CANTOR",
        "first_name": "LISA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005338",
            "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 Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.