Individual provider Active NPI

Joshua R Wolff, PH.D.

  • Psychologist
  • Chicago, IL
National Provider Identifier
1558741322
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS01235 Issued in RI
Practice address
17 N Dearborn St
Chicago, IL 60602-4310
Phone
(312) 662-4371
NPI assigned
Jun 5, 2015
Last updated
Jun 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS01235 RI Primary
Psychologist 103T00000X 071.009007 IL

Addresses

Primary practice location

17 N Dearborn St
Chicago, IL 60602-4310

Mailing address

17 N Dearborn St
Chicago, IL 60602-4310
Phone (312) 662-4371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.009007ILMDPsychologist
PS01235RIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1558741322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 N DEARBORN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606024310",
            "telephone_number": "312-662-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N DEARBORN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606024310",
            "telephone_number": "312-662-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "JOSHUA",
        "middle_name": "R",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "RI",
            "license": "PS01235",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.009007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.