Active NPI
Anna Benton, PHD
- School Psychologist
- Libertyville, IL
National Provider Identifier
1568150548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 2449464
- Practice address
- 1585 N Milwaukee Ave Ste 9
Libertyville, IL 60048-1359 - Phone
- (224) 707-4321
- NPI assigned
- Apr 27, 2023
- Last updated
- Apr 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 2449464 | IL | Primary |
Addresses
Primary practice location
1585 N Milwaukee Ave Ste 9
Libertyville, IL 60048-1359
Mailing address
2678 Franklin CT
Lindenhurst, IL 60046-4983
Phone (224) 944-7531
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2449464 | IL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682553600000",
"number": "1568150548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2678 FRANKLIN CT",
"city": "LINDENHURST",
"state": "IL",
"postal_code": "600464983",
"telephone_number": "224-944-7531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1585 N MILWAUKEE AVE STE 9",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600481359",
"telephone_number": "224-707-4321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTON",
"first_name": "ANNA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-27",
"last_updated": "2023-04-27",
"certification_date": "2023-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IL",
"license": "2449464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Libertyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.