Andrew McKenzie, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.008021 Issued in IL

Practice address

5547 N Ravenswood Ave Ste 409
Chicago, IL 60640-1125

Phone

(773) 234-8810

Fax

(773) 312-5418

NPI assigned

Jan 14, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Momentum Psychotherapy, PLLC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1174290936
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1487959953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5547 N RAVENSWOOD AVE STE 409",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401125",
            "telephone_number": "773-234-8810",
            "fax_number": "773-312-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5547 N RAVENSWOOD AVE STE 409",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401125",
            "telephone_number": "773-234-8810",
            "fax_number": "773-312-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-14",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew John McKenna, PA-C
• Patricia Anne McKenna, PH.D.
• Samantha Ashlyn McKenna, M.S. CCC-SLP
• Kasey McKenney, L.AC
• Theresa Elaine McKennie, LPC
• Anna McKenzie, MD
• Jessica Brianna McKenzie
• Nicholas Lance McKenzie
• Katherine Annette McKeough
• Nora Kathleen McKeough

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.