Individual provider Active NPI

Amanda Ori, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1477921237
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.009744 Issued in IL
Practice address
2000 N Racine Ave
Chicago, IL 60614-7006
Phone
(773) 340-0796
NPI assigned
Sep 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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 071.009744 IL Primary

Addresses

Primary practice location

2000 N Racine Ave
Chicago, IL 60614-7006

Mailing address

2000 N Racine Ave Ste 2184
Chicago, IL 60614-7007
Phone (773) 340-0796

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
071.009744ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ao Psychological Services LLC Clinical CurrentSince Jan 22, 2023 Accepting new patients
Mainsail Therapeutics LLC PastSince Dec 15, 2019 Accepting new patients

Locations

2000 N Racine Ave
Ste 2184
Chicago, IL 60614
Phone (312) 485-3669

Organizations & group practices 2

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": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1477921237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N RACINE AVE STE 2184",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147007",
            "telephone_number": "773-340-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N RACINE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147006",
            "telephone_number": "773-340-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORI",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009744",
            "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 Aug 1, 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.