NPIMap

Organization Active NPI

Associated Clinical Psychologists, LTD

Doing business as ACP Consultants

  • Clinical Psychologist
  • Park Ridge, IL
National Provider Identifier
1578665147
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
ASSOCIATED CLINICAL PSYCHOLOGISTS, LTD
Doing business as
ACP Consultants
Practice address
1580 N Northwest Hwy
Suite 311D
Park Ridge, IL 60068-1444
Phone
(847) 824-1235
Fax
(847) 824-2386
NPI assigned
Sep 2, 2006
Last updated
Aug 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Authorized official

Name
Dr. Alan R. Graham, PH.DNPI 1801987581
Title
President
Phone
(847) 824-1235

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary
Clinical Social Worker 1041C0700X
Nutritionist 133N00000X

Addresses

Primary practice location

1580 N Northwest Hwy
Suite 311D
Park Ridge, IL 60068-1444

Mailing address

1580 N Northwest Hwy
Suite 311D
Park Ridge, IL 60068-1444
Phone (847) 824-1235

Other names 1

  • ACP Consultants Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160919000110 IL Part B Supplier - Clinic/Group Practice 4981991031 Receives reassigned benefits from 5 practitioners
Practice locations: Park Ridge, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1578665147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 N NORTHWEST HWY",
            "address_2": "SUITE 311D",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681444",
            "telephone_number": "847-824-1235",
            "fax_number": "847-824-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 N NORTHWEST HWY",
            "address_2": "SUITE 311D",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681444",
            "telephone_number": "847-824-1235",
            "fax_number": "847-824-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED CLINICAL PSYCHOLOGISTS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-824-1235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACP Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.