Kelly Ristau, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009856 Issued in IL

Practice address

640 N River Rd Ste 108
Naperville, IL 60563-8947

Phone

(630) 718-0717

NPI assigned

Sep 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Valley Institute for Growth and Wellness Inc

  • Counselor
  • Naperville, IL
  • NPI 1174637334
  Medicare reassignment NPD
• Revelations RX PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Naperville, IL
  • NPI 1265124846
  NPD
• Chicagoland Neuropsychology LLC

  • Clinical Neuropsychologist
  • Oak Park, IL
  • NPI 1275946048
  NPD (past)

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1467174540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4555",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605674555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N RIVER RD STE 108",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638947",
            "telephone_number": "630-718-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISTAU",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "IL",
            "license": "071.009856",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Beck Riordan, LCSW
• Kathryn Riordan
• Kyle W Rippel, O.D.
• Ripple Therapeutic Serveces (Ripple Therapeutic Services)
• Roople Risam, MD
• Diana Ritter, LCSW
• Nancy E.M. Rivas, PHD
• Nicholas Jacob Rivera
• Ramses Delatorre Rivera, PT
• Riverwalk Adult Day Services

• Clinical Psychologist in Naperville, IL
• Providers in Naperville, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.