NPIMap

Organization Active NPI

Integrative Therapeutic Solutions PC

  • Clinical Psychologist
  • Plainfield, IL
National Provider Identifier
1508460700
Registry record updated Nov 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
INTEGRATIVE THERAPEUTIC SOLUTIONS PC
Practice address
24012 W Renwick Rd Ste 204
Plainfield, IL 60544-8733
Phone
(815) 676-4688
Fax
(815) 676-4498
NPI assigned
Nov 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2020

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

Authorized official

Name
Dr. Emmanuel Gonzalez, PSY.D.NPI 1679182273
Title
Licensed Clinical Psychologist
Phone
(815) 676-4688

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0700X
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Health PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0004X

Addresses

Primary practice location

24012 W Renwick Rd Ste 204
Plainfield, IL 60544-8733

Mailing address

24012 W Renwick Rd Ste 204
Plainfield, IL 60544-8733
Phone (815) 676-4688

National Provider Directory

National Provider Directory

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": "1606521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606521600000",
    "number": "1508460700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24012 W RENWICK RD STE 204",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448733",
            "telephone_number": "815-676-4688",
            "fax_number": "815-676-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24012 W RENWICK RD STE 204",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448733",
            "telephone_number": "815-676-4688",
            "fax_number": "815-676-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE THERAPEUTIC SOLUTIONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-28",
        "last_updated": "2020-11-28",
        "certification_date": "2020-11-28",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "815-676-4688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2020; 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.