Dianne Burgin, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.002303 Issued in IL

Practice address

405 N Wabash Ave
Suite 606
Chicago, IL 60611-3591

Phone

(312) 222-9797

NPI assigned

Aug 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Victoria Dianne Burgin Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1154822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497764666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012617",
            "telephone_number": "847-328-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE",
            "address_2": "SUITE 606",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113591",
            "telephone_number": "312-222-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGIN",
        "first_name": "DIANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.002303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "BURGIN",
            "middle_name": "DIANNE",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kelly Rebecca Burgess, MS, CGC
• Michele J Burgess, MD
• Phyllis Veronica Burgess, APN MSN
• Sheila Lester Burgess, MA
• Yolanda Burgess, LCSW
• Ana Thrall Burgoon, MS, CCC-SLP
• Brandy Burgos, MD
• Kayla Burgos
• Ketty Burgos
• Natalia Elena Burgos, BCBA

• 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 Jul 8, 2007; 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.