Individual provider Active NPI

Angela Ceisel, PSY. D.

  • Psychologist
  • Northbrook, IL
National Provider Identifier
1497092118
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071-008493 Issued in IL
Practice address
605 Landwehr Rd
Northbrook, IL 60062-2309
Phone
(224) 800-1317
NPI assigned
Jan 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071-008493 IL Primary

Addresses

Primary practice location

605 Landwehr Rd
Northbrook, IL 60062-2309

Mailing address

605 Landwehr Rd
Northbrook, IL 60062-2309
Phone (224) 800-1317

Other practice location 1

350 Pfingsten Rd
Suite 101
Northbrook, IL 60062-2032
Phone (224) 800-1317

Other practice location 2

350 Pfingsten Rd
Suite 101
Northbrook, IL 60062-2032
Phone (224) 800-1317

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130507000243 IL Practitioner - Clinical Psychologist 8325285596 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-008493ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Pathways PLLC Psychologist CurrentSince Jul 23, 2023 Accepting new patients

Locations

605 Landwehr Rd
Northbrook, IL 60062
Phone (224) 723-5772

350 Pfingsten Rd
Ste 101
Northbrook, IL 60062
Phone (224) 723-5772

617 Landwehr Rd
Northbrook, IL 60062
Phone (224) 723-5772

Organizations & group practices 1

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": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1497092118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 LANDWEHR RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622309",
            "telephone_number": "224-800-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 LANDWEHR RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622309",
            "telephone_number": "224-800-1317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Pfingsten Rd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600622032",
            "country_code": "US",
            "telephone_number": "224-800-1317",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Pfingsten Rd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600622032",
            "country_code": "US",
            "telephone_number": "224-800-1317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEISEL",
        "first_name": "ANGELA",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071-008493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.