Active NPI
Christine Ann Porter, MA, PSY.D
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1497304026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.010097
- Practice address
- 4001 W Devon Ave
Chicago, IL 60646-4523 - Phone
- (837) 477-1607
- NPI assigned
- Sep 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.010097 | IL | Primary |
Addresses
Primary practice location
4001 W Devon Ave
Chicago, IL 60646-4523
Mailing address
7601 Lincoln Ave Apt 414
Skokie, IL 60077-2858
Phone (847) 477-1607
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.010097 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567728000000",
"number": "1497304026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7601 LINCOLN AVE APT 414",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600772858",
"telephone_number": "847-477-1607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 W DEVON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606464523",
"telephone_number": "837-477-1607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "CHRISTINE",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "MA, PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-06",
"last_updated": "2019-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.010097",
"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 Sep 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.