Colin A. Brietzke, PSY. D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071.008376 Issued in IL

Practice address

1011 Lake St Ste 200
Oak Park, IL 60301-1137

Phone

(708) 320-1441

NPI assigned

Jul 9, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Chicagoland Neuropsychology LLC

  • Clinical Neuropsychologist
  • Oak Park, IL
  • NPI 1275946048
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1558626267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 LAKE ST STE 200",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011137",
            "telephone_number": "708-320-1411",
            "fax_number": "708-328-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 LAKE ST STE 200",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011137",
            "telephone_number": "708-320-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIETZKE",
        "first_name": "COLIN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008376",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071008376",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Forensic",
            "state": "IL",
            "license": "071.008376",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071.008376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Maureen Brennan-Johnson
• Sherri Ann Brennan, R.D.
• Brian a. King
• Jasmine Haley Brice
• Bridgemark Medical Supply LLC
• Justine Britten, RDN
• Esther S. Brodsky, LCSW
• Brittney Brooks, MA
• Deasia I Brooks
• Monique Brotman, D.O.

• Clinical Neuropsychologist in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.