Individual provider Active NPI

Michelle Bailleaux-Rago, PSYD LCPC

  • Psychologist
  • Arlington Heights, IL
National Provider Identifier
1487759700
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
3250 N Arlington HTS Rd
Suite 112
Arlington Heights, IL 60067
Phone
(847) 767-2120
Fax
(847) 368-0764
NPI assigned
Sep 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X IL Primary

Addresses

Primary practice location

3250 N Arlington HTS Rd
Suite 112
Arlington Heights, IL 60067

Mailing address

3250 N Arlington HTS Rd
Suite 112
Arlington Heights, IL 60067
Phone (847) 767-2120

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
180005124ILMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487759700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 N ARLINGTON HTS RD",
            "address_2": "SUITE 112",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "60067",
            "telephone_number": "847-767-2120",
            "fax_number": "847-368-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 N ARLINGTON HTS RD",
            "address_2": "SUITE 112",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "60067",
            "telephone_number": "847-767-2120",
            "fax_number": "847-368-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILLEAUX-RAGO",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PSYD  LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.