Individual provider Active NPI

Kenneth A Fils, PH.D.

  • Clinical Psychologist
  • Northbrook, IL
National Provider Identifier
1487694279
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-003011 Issued in IL
Practice address
420 Anjou Dr
Northbrook, IL 60062-2211
Phone
(630) 362-9192
Fax
(847) 673-0875
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 071-003011 IL Primary

Addresses

Primary practice location

420 Anjou Dr
Northbrook, IL 60062-2211

Mailing address

PO Box 9220
Aurora, IL 60598-9220
Phone (303) 629-1926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110128001003 IL Practitioner - Clinical Psychologist 4688587579 Reassigns benefits to 1 organization
I20260507002224 IN Practitioner - Clinical Psychologist 4688587579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3426 W Touhy Ave
Skokie, IL 60076-6217

590 N Kimball Ave
Suite 100
Southlake, TX 76092-6878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-003011ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Davken Associates, P.C. Clinical CurrentSince Jan 1, 1995 Accepting new patients

Locations

8170 McCormick Blvd
Ste 204
Skokie, IL 60076
Phone (847) 410-2029

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1487694279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9220",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605989220",
            "telephone_number": "303-629-1926",
            "fax_number": "847-673-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 ANJOU DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622211",
            "telephone_number": "630-362-9192",
            "fax_number": "847-673-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILS",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2024-01-31",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-003011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.