Northside Psychology Services PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

NORTHSIDE PSYCHOLOGY SERVICES PLLC

Practice address

4609 N Wolcott Ave
Chicago, IL 60640-4303

Phone

(773) 217-8599

NPI assigned

Aug 8, 2024

Organization subpart

No

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

Authorized official

Name

Hannah Carl

Title

Owner

Phone

(773) 217-8599

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Jillian Thrall, PHD

  • Psychologist
  • Chicago, IL
  • NPI 1639730310
  NPD

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1548091036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 N WOLCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 N WOLCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404303",
            "telephone_number": "773-217-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE PSYCHOLOGY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "CARL",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-217-8599"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.