Individual provider Active NPI

Timothy Robert Tumlin, PH.D.

  • Clinical Psychologist
  • Burr Ridge, IL
National Provider Identifier
1477522001
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-005256 Issued in IL
Practice address
100 Tower Dr
Suite 120
Burr Ridge, IL 60527-5777
Phone
(630) 371-1556
Fax
(630) 371-1555
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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 071-005256 IL Primary

Addresses

Primary practice location

100 Tower Dr
Suite 120
Burr Ridge, IL 60527-5777

Mailing address

100 Tower Dr
Suite 120
Burr Ridge, IL 60527-5778
Phone (630) 371-1556

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-005256ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1477522001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TOWER DR",
            "address_2": "SUITE 120",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275778",
            "telephone_number": "630-371-1556",
            "fax_number": "630-371-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TOWER DR",
            "address_2": "SUITE 120",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275777",
            "telephone_number": "630-371-1556",
            "fax_number": "630-371-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMLIN",
        "first_name": "TIMOTHY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.