Individual provider Active NPI

Noah Yulish, PHD

  • Clinical Psychologist
  • Hines, IL
National Provider Identifier
1457822801
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-009904 Issued in IL
Practice address
5000 S 5TH Ave
Hines, IL 60141-3030
Phone
(708) 202-8387
NPI assigned
Dec 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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 071-009904 IL Primary

Addresses

Primary practice location

5000 S 5TH Ave
Hines, IL 60141-3030

Mailing address

216 N Harvey Ave Apt 2
Oak Park, IL 60302-2333
Phone (202) 441-1787

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
I20190430001414 IL Practitioner - Clinical Psychologist 2961744602 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-009904ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Clinical CurrentSince Apr 15, 2019 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Apr 15, 2019 Accepting new patients

Locations

7825 Solution Ctr
Chicago, IL 60677

912 S Wood St
Chicago, IL 60612
Phone (312) 996-2200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1457822801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 N HARVEY AVE APT 2",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022333",
            "telephone_number": "202-441-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "708-202-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YULISH",
        "first_name": "NOAH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-11",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-009904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hines, IL

Sources for this page

Verify at the official NPI Registry.