Individual provider Active NPI

Richard Cockerill, MD

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1598159709
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036152322 Issued in IL
Practice address
3838 N Ravenswood Ave
Ste 255
Chicago, IL 60613
Phone
(708) 475-0788
Fax
(888) 312-9495
NPI assigned
Mar 25, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A144800 CA
Psychiatry Physician 2084P0800X 036152322 IL Primary

Addresses

Primary practice location

3838 N Ravenswood Ave
Ste 255
Chicago, IL 60613

Mailing address

3838 N Ravenswood Ave
Ste 255
Chicago, IL 60613
Phone (708) 475-0788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161222001002 CA Practitioner - Psychiatry 9931480316 Reassigns benefits to 1 organization
I20200627000054 IL Practitioner - PsychiatryPractitioner - Neuropsychiatry 9931480316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A144800CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Auditor Controller CurrentSince Dec 1, 2016 Accepting new patients
The University of Chicago Medical Center CurrentSince Mar 17, 2022 Accepting new patients
County of Los Angeles CurrentSince Dec 1, 2016 Accepting new patients
County of Los Angeles Current Accepting new patients
The University of Chicago Medical Center CurrentSince Mar 17, 2022 Accepting new patients
UCLA Past Accepting new patients

Locations

14445 Olive View Dr
#2C155
Sylmar, CA 91342
Phone (818) 364-3001

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

Organizations & group practices 6

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": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1598159709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 N RAVENSWOOD AVE",
            "address_2": "STE 255",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60613",
            "telephone_number": "708-475-0788",
            "fax_number": "888-312-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N RAVENSWOOD AVE",
            "address_2": "STE 255",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60613",
            "telephone_number": "708-475-0788",
            "fax_number": "888-312-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKERILL",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A144800",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036152322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.