Judy Tisdall, PSY.D., LCPC

Primary specialty

PsychoanalystTaxonomy code 102L00000X

Practice address

953 N Plum Grove Rd
Suite B
Schaumburg, IL 60173-5189

Phone

(847) 413-9001

Fax

(847) 413-0491

NPI assigned

May 21, 2008

Last updated

May 21, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1568629004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 N PLUM GROVE RD",
            "address_2": "SUITE B",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735189",
            "telephone_number": "847-413-9001",
            "fax_number": "847-413-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 N PLUM GROVE RD",
            "address_2": "SUITE B",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735189",
            "telephone_number": "847-413-9001",
            "fax_number": "847-413-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALL",
        "first_name": "JUDY",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychoanalyst in Schaumburg, IL
• Providers in Schaumburg, IL by specialty
• Psychoanalyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.