Individual provider Active NPI

Deidra L Bibbs, PHD, HSPP, NCSP

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1457934762
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071011463 Issued in IL
Practice address
6127 S University Ave Ste 1090
Chicago, IL 60637-7425
Phone
(773) 830-4005
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 40952 TX
Psychologist 103T00000X 20043964B IN
Clinical Psychologist 103TC0700X 071011463 IL Primary
School Psychologist 103TS0200X

Addresses

Primary practice location

6127 S University Ave Ste 1090
Chicago, IL 60637-7425

Mailing address

7658 S Aberdeen St Apt 2
Chicago, IL 60620-3666
Phone (773) 294-2528

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1457934762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7658 S ABERDEEN ST APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606203666",
            "telephone_number": "773-294-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6127 S UNIVERSITY AVE STE 1090",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606377425",
            "telephone_number": "773-830-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBBS",
        "first_name": "DEIDRA",
        "middle_name": "L",
        "credential": "PHD, HSPP, NCSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "40952",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20043964B",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071011463",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jul 27, 2026; 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.