Organization Active NPI

Michael R Binder

  • Psychologist
  • Highland Park, IL
National Provider Identifier
1578693180
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
036-96922 Issued in IL
Legal business name
MICHAEL R BINDER
Practice address
767 Park Ave W
Suite 210
Highland Park, IL 60035-2400
Phone
(262) 691-2581
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael R Binder, M.D.NPI 1083632590
Title
Owner
Phone
(262) 691-2581

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 036-96922 IL Primary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 30357-020 WI

Addresses

Primary practice location

767 Park Ave W
Suite 210
Highland Park, IL 60035-2400

Mailing address

767 Park Ave W
Suite 210
Highland Park, IL 60035-2400
Phone (262) 691-2581

Other identifiers 1

IdentifierTypeStateIssuer
31798800MedicaidWI

National Provider Directory

National Provider Directory

Locations

767 Park Ave W
Ste 210
Highland Park, IL 60035
Phone (262) 691-2581

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578693180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 PARK AVE W",
            "address_2": "SUITE 210",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352400",
            "telephone_number": "262-691-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 PARK AVE W",
            "address_2": "SUITE 210",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352400",
            "telephone_number": "262-691-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R BINDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BINDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-691-2581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": "036-96922",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "WI",
            "license": "30357-020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31798800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.