Individual provider Active NPI

Olivia D Chavez, PSYD

  • Psychologist
  • Chicago, IL
National Provider Identifier
1467790766
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071.008494 Issued in IL
Practice address
2650 W Montrose Ave Ste 307
Chicago, IL 60618-1561
Phone
(773) 217-0277
NPI assigned
Jan 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.008494 IL Primary

Addresses

Primary practice location

2650 W Montrose Ave Ste 307
Chicago, IL 60618-1561

Mailing address

4239 W Wrightwood Ave
Chicago, IL 60639-2059
Phone (773) 217-0277

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

State licenses

LicenseStateTypeSpecialty
071.008494ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Olivia Chavez, PLLC Psychologist CurrentSince Aug 1, 2019 Accepting new patients

Locations

2650 W Montrose Ave
Ste 307
Chicago, IL 60618
Phone (312) 463-9439

53 W Jackson Blvd
Ste 564
Chicago, IL 60604
Phone (872) 216-0658

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": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1467790766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4239 W WRIGHTWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392059",
            "telephone_number": "773-217-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 W MONTROSE AVE STE 307",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181561",
            "telephone_number": "773-217-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "OLIVIA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-21",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.008494",
            "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 Dec 16, 2022; 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.