Sandra J Fallon, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071005007 Issued in IL

Practice address

4624 Johnson Ave
Western Springs, IL 60558

Phone

(708) 203-9845

Fax

(708) 246-3408

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1487766127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 JOHNSON AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "60558",
            "telephone_number": "708-203-9845",
            "fax_number": "708-246-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 JOHNSON AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "60558",
            "telephone_number": "708-203-9845",
            "fax_number": "708-246-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "SANDRA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005007",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041094355",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001635216",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackie Espinoza
• Preston Fairchild Jr., MSW, QMHP
• Toluwanimi Falana
• Jarethia Falkner
• Julie Fallon, LCSW
• Sara Fatima, PTA
• Vladimir Fedin, DDS
• Carolyn Ferguson
• Blanca Margarita Figueroa
• Aaron Findley, LSW

• Clinical Psychologist in Western Springs, IL
• Providers in Western Springs, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.