Organization Active NPI

Spectrum Psychological Services Inc.

  • Clinical Psychologist
  • Darien, IL
National Provider Identifier
1568980241
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009197 Issued in IL
Legal business name
SPECTRUM PSYCHOLOGICAL SERVICES INC.
Practice address
7717 Stevens St
Darien, IL 60561
Phone
(630) 710-2002
NPI assigned
Sep 1, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Erica Irene Essary, PSYDNPI 1295192094
Title
President
Phone
(630) 310-9957

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 071009197 IL Primary

Addresses

Primary practice location

7717 Stevens St
Darien, IL 60561

Mailing address

7717 Stevens St
Darien, IL 60561-4427
Phone (630) 710-2002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180521000889 IL Part B Supplier - Clinic/Group Practice 4385909415 Receives reassigned benefits from 1 practitioner
Practice locations: Darien, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1568980241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7717 STEVENS ST",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605614427",
            "telephone_number": "630-710-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7717 STEVENS ST",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "60561",
            "telephone_number": "630-710-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM PSYCHOLOGICAL SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ESSARY",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-310-9957",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darien, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.