Individual provider Active NPI

Laura T Schultz, PSY.D.

  • Clinical Psychologist
  • Joliet, IL
National Provider Identifier
1548263379
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-004309 Issued in IL
Practice address
13 Fairlane Dr
Joliet, IL 60435-6483
Phone
(312) 802-1956
NPI assigned
May 24, 2005
Last updated
May 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-004309 IL Primary

Addresses

Primary practice location

13 Fairlane Dr
Joliet, IL 60435-6483

Mailing address

13 Fairlane Dr
Joliet, IL 60435-6483
Phone (312) 802-1956

Other identifiers 1

IdentifierTypeStateIssuer
IL5230OtherILPART B

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080410000562 IL Practitioner - Clinical Psychologist 3072690346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2233 Theodore St
Suite 4
Crest Hill, IL 60403-5856
Phone (815) 931-3131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-004309ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness Center Metro of Sauganash LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1548263379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 FAIRLANE DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356483",
            "telephone_number": "312-802-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 FAIRLANE DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356483",
            "telephone_number": "312-802-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "LAURA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-004309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PART B",
            "identifier": "IL5230",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.