Active NPI
Brian T. Madvig, PH.D.
- Clinical Psychologist
- Wheaton, IL
National Provider Identifier
1467464792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Practice address
- 1725 S Naperville Rd
Suite 207
Wheaton, IL 60187-8155 - Phone
- (630) 462-7005
- Fax
- (630) 462-7006
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | IL | Primary |
Addresses
Primary practice location
1725 S Naperville Rd
Suite 207
Wheaton, IL 60187-8155
Mailing address
1725 S Naperville Rd
Suite 207
Wheaton, IL 60187-8155
Phone (630) 462-7005
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170412000528 | IL | Practitioner - Clinical Psychologist | 5395021075 |
Receives reassigned benefits from 6 practitioners Practice locations: Wheaton, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1725 S Naperville Rd
Suite 207
Wheaton, IL 60189-5855
Phone 630462700513
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-005079 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian Timothy Madvig | Clinical | Past | Accepting new patients |
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Organizations & group practices 1
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": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467464792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1725 S NAPERVILLE RD",
"address_2": "SUITE 207",
"city": "WHEATON",
"state": "IL",
"postal_code": "601878155",
"telephone_number": "630-462-7005",
"fax_number": "630-462-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 S NAPERVILLE RD",
"address_2": "SUITE 207",
"city": "WHEATON",
"state": "IL",
"postal_code": "601878155",
"telephone_number": "630-462-7005",
"fax_number": "630-462-7006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADVIG",
"first_name": "BRIAN",
"middle_name": "T.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.