Kenneth Kessler, PH.D., MSCP

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

074-000015 Issued in IL

Practice address

5201 Willow Springs Rd Ste 120
La Grange Highlands, IL 60525-6540

Phone

(708) 579-0974

NPI assigned

Nov 13, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1384300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1588094403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 695",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600600695",
            "telephone_number": "708-579-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD STE 120",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256540",
            "telephone_number": "708-579-0974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Green Bay Rd",
            "address_2": "Department of Psychology",
            "address_purpose": "LOCATION",
            "city": "North Chicago",
            "state": "IL",
            "postal_code": "600643037",
            "country_code": "US",
            "telephone_number": "847-578-8740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KESSLER",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "PH.D., MSCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-13",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "IL",
            "license": "074-000015",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prescribing (Medical) Psychologist in La Grange Highlands, IL
• Providers in La Grange Highlands, IL by specialty
• Prescribing (Medical) Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.