Active NPI
Dennis R Verville, PSYD
- Clinical Psychologist
- Oak Park, IL
National Provider Identifier
1497888275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-006281
- Practice address
- 1100 Lake St Ste 280-D
Oak Park, IL 60301-1015 - Phone
- (708) 205-8028
- Fax
- (855) 847-4919
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- 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 | 071-006281 | IL | Primary |
Addresses
Primary practice location
1100 Lake St Ste 280-D
Oak Park, IL 60301-1015
Mailing address
1100 Lake St Ste 280-D
Oak Park, IL 60301-1015
Phone (708) 205-8028
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-006281 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517788800000",
"number": "1497888275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 LAKE ST STE 280-D",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603011015",
"telephone_number": "708-205-8028",
"fax_number": "855-847-4919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 LAKE ST STE 280-D",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603011015",
"telephone_number": "708-205-8028",
"fax_number": "855-847-4919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERVILLE",
"first_name": "DENNIS",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2018-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-006281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.