Individual provider Active NPI

Paul J Mullen, PSY. D.

  • Psychologist
  • Naperville, IL
National Provider Identifier
1588743231
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
1776 Legacy Cir Ste 114
Naperville, IL 60563-1673
Phone
(630) 653-1000
Fax
(630) 653-1010
NPI assigned
Nov 3, 2006
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

1776 Legacy Cir Ste 114
Naperville, IL 60563-1673

Mailing address

1776 Legacy Cir Ste 114
Naperville, IL 60563-1673
Phone (630) 653-1000

Other practice location 1

5151 Mochel Dr Ste 305
Downers Grove, IL 60515-5078
Phone (630) 653-1000 ext. 700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251001002547 IL Practitioner - Clinical Psychologist 6305265158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1776 Legacy Cir
Suite 114
Naperville, IL 60563-1642

PO Box
Suite 1974
Oak Park, IL 60304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paul J Mullen Psy D P C CurrentSince Aug 12, 2025 Accepting new patients

Locations

5151 Mochel Dr
Ste 305
Downers Grove, IL 60515
Phone 6306531000 ext. 700

1776 Legacy Cir
Ste 114
Naperville, IL 60563
Phone (630) 653-1000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1588743231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 LEGACY CIR STE 114",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631673",
            "telephone_number": "630-653-1000",
            "fax_number": "630-653-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 LEGACY CIR STE 114",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631673",
            "telephone_number": "630-653-1000",
            "fax_number": "630-653-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5151 Mochel Dr Ste 305",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605155078",
            "country_code": "US",
            "telephone_number": "630-653-1000 x700",
            "fax_number": "630-653-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "PAUL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.