Organization Active NPI

Cecily Kanter Center for Psychological Services Incorporate

  • Clinical Psychologist
  • Buffalo Grove, IL
National Provider Identifier
1558100545
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CECILY KANTER CENTER FOR PSYCHOLOGICAL SERVICES INCORPORATE
Practice address
750 W Lake Cook Rd Ste 105
Buffalo Grove, IL 60089-2093
Phone
(847) 814-5031
Fax
(847) 259-8891
NPI assigned
May 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Cecily Kanter, PSYDNPI 1245575059
Title
Owner
Phone
(847) 525-7504

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

750 W Lake Cook Rd Ste 105
Buffalo Grove, IL 60089-2093

Mailing address

750 W Lake Cook Rd Ste 105
Buffalo Grove, IL 60089-2093
Phone (847) 814-5031

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240706000247 IL Part B Supplier - Clinic/Group Practice 0648714279 Receives reassigned benefits from 1 practitioner
Practice locations: Buffalo Grove, IL

National Provider Directory

National Provider Directory

Locations

1151 McHenry Rd
Buffalo Grove, IL 60089

750 W Lake Cook Rd
Ste 105
Buffalo Grove, IL 60089
Phone (312) 872-8210

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": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1558100545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W LAKE COOK RD STE 105",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892093",
            "telephone_number": "847-814-5031",
            "fax_number": "847-259-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W LAKE COOK RD STE 105",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892093",
            "telephone_number": "847-814-5031",
            "fax_number": "847-259-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CECILY KANTER CENTER FOR PSYCHOLOGICAL SERVICES INCORPORATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "KANTER",
        "authorized_official_first_name": "CECILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-525-7504",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.