Individual provider Active NPI

Jennifer Susan Lonosky, PSY.D.

  • Clinical Psychologist
  • Libertyville, IL
National Provider Identifier
1487792719
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-006522 Issued in IL
Practice address
1105 W Park Ave
Suite 2
Libertyville, IL 60048-2567
Phone
(847) 362-5601
Fax
(847) 362-5611
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 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 071-006522 IL Primary

Addresses

Primary practice location

1105 W Park Ave
Suite 2
Libertyville, IL 60048-2567

Mailing address

789 Barclay Dr
Bolingbrook, IL 60440-6105
Phone (630) 346-6155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 11, 2024 through Dec 11, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-006522ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer S Lonosky PSYD Clinical Past Accepting new patients
Richard P Weber Psy.D. Past Accepting new patients

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1487792719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 BARCLAY DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604406105",
            "telephone_number": "630-346-6155",
            "fax_number": "847-362-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 W PARK AVE",
            "address_2": "SUITE 2",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482567",
            "telephone_number": "847-362-5601",
            "fax_number": "847-362-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONOSKY",
        "first_name": "JENNIFER",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-006522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.