Individual provider Active NPI

Joanna Buscemi, PHD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1497473649
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008604 Issued in IL
Practice address
2502 N Clark St Ste 206
Chicago, IL 60614-1850
Phone
(773) 850-0294
NPI assigned
Aug 15, 2022
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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 071008604 IL Primary

Addresses

Primary practice location

2502 N Clark St Ste 206
Chicago, IL 60614-1850

Mailing address

2502 N Clark St Ste 206
Chicago, IL 60614-1850

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
I20221018000017 IL Practitioner - Clinical Psychologist 3274909221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chicago Behavioral Clinic LLCGroup PAC ID 6204169253, 4 clinicians

Practice addresses (Care Compare)

2502 N Clark St
Suite 206
Chicago, IL 60614-1850
Phone (773) 850-0294

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071008604ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Behavioral Clinic LLC Clinical CurrentSince Sep 14, 2022 Accepting new patients

Locations

2502 N Clark St
Ste 206
Chicago, IL 60614
Phone (773) 850-0294

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1497473649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 N CLARK ST STE 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 N CLARK ST STE 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141850",
            "telephone_number": "773-850-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCEMI",
        "first_name": "JOANNA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.