Organization Active NPI

Brenda Ann Husfeldt PHD LTD

  • Psychologist
  • Skokie, IL
National Provider Identifier
1497875033
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
BRENDA ANN HUSFELDT PHD LTD
Practice address
9933 Lawler Ave
Suite 314
Skokie, IL 60077-3703
Phone
(773) 775-1622
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Brenda Ann Husfeldt, PHD LTDNPI 1487723367
Title
PHD LTD
Phone
(773) 775-1622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X IL Primary

Addresses

Primary practice location

9933 Lawler Ave
Suite 314
Skokie, IL 60077-3703

Mailing address

6547 N Avondale Ave
Suite 001
Chicago, IL 60631-1573
Phone (773) 775-1622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051021000175 IL Part B Supplier - Clinic/Group Practice 7719903459 Receives reassigned benefits from 1 practitioner
Practice locations: Skokie, IL; Chicago, IL

National Provider Directory

National Provider Directory

Locations

1611 W Harrison St
#212
Chicago, IL 60612
Phone (312) 432-2850

9933 Lawler Ave
Ste 314
Skokie, IL 60077
Phone (773) 520-9725

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497875033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6547 N AVONDALE AVE",
            "address_2": "SUITE 001",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311573",
            "telephone_number": "773-775-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE",
            "address_2": "SUITE 314",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773703",
            "telephone_number": "773-775-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENDA ANN HUSFELDT PHD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUSFELDT",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PHD LTD",
        "authorized_official_telephone_number": "773-775-1622",
        "authorized_official_credential": "PHD LTD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.