August John Crivolio, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Practice address

333 E Ontario St
Suite 301B
Chicago, IL 60611-4804

Phone

(312) 951-0157

Fax

(312) 951-0193

NPI assigned

Apr 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 5, 2017 through Jul 5, 2027

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": "1176508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497970644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E ONTARIO ST",
            "address_2": "SUITE 301B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114804",
            "telephone_number": "312-951-0157",
            "fax_number": "312-951-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E ONTARIO ST",
            "address_2": "SUITE 301B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114804",
            "telephone_number": "312-951-0157",
            "fax_number": "312-951-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIVOLIO",
        "first_name": "AUGUST",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1672476",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lajuan Criswell, OTR/L
• Margaret Criswell
• Daniel Critchfield
• Penelope S. Crittenden, PH.D.
• Simone Crivellaro, MD
• Kathryn Crivolio, D T
• Crna Stat Inc
• Joseph A Crnich, PT, DPT, SCS
• Brittony Croasdell, FNP-BC
• Elizabeth Croce, MD

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.