Individual provider Active NPI

Rebecca Mach, PSY.D.

  • Psychologist
  • Chicago, IL
National Provider Identifier
1497007520
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071.009505 Issued in IL
Practice address
5844 N Hermitage Ave Apt B
102A
Chicago, IL 60660-8901
Phone
(773) 495-6614
Fax
(206) 202-2205
NPI assigned
Oct 13, 2012
Last updated
Mar 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180008288 IL
Psychologist 103T00000X 071.009505 IL Primary

Addresses

Primary practice location

5844 N Hermitage Ave Apt B
102A
Chicago, IL 60660-8901

Mailing address

5844 N Hermitage Ave
Apt B
Chicago, IL 60660-3192
Phone (773) 495-6614

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
180008288ILMDProfessional Counselor
071.009505ILMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1350086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1497007520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5844 N HERMITAGE AVE",
            "address_2": "APT B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603192",
            "telephone_number": "773-495-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5844 N HERMITAGE AVE APT B",
            "address_2": "102A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606608901",
            "telephone_number": "773-495-6614",
            "fax_number": "206-202-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACH",
        "first_name": "REBECCA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-13",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008288",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.009505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.