Individual provider Active NPI

Kari Alysse Weiterschan, PHD

  • Clinical Psychologist
  • Palatine, IL
National Provider Identifier
1598438608
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.010619 Issued in IL
Practice address
579 N 1St Bank Dr Ste 150
Palatine, IL 60067-8102
Phone
(312) 945-7566
NPI assigned
Jul 26, 2021
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.010619 IL Primary

Addresses

Primary practice location

579 N 1St Bank Dr Ste 150
Palatine, IL 60067-8102

Mailing address

579 N 1St Bank Dr Ste 150
Palatine, IL 60067-8102
Phone (312) 945-7566

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
I20211022000059 IL Practitioner - Clinical Psychologist 6800284910 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

579 N 1St Bank Dr
Suite 150
Palatine, IL 60067-8102
Phone (312) 945-7566

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071.010619ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Clinic PLLC Counselor CurrentSince Sep 23, 2021 Accepting new patients
Evolve Healing and Wellness Center CurrentSince Apr 1, 2023 Accepting new patients

Locations

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

333 N Michigan Ave
Ste 1400
Chicago, IL 60601
Phone (312) 815-9660

579 N 1st Bank Dr
Ste 150
Palatine, IL 60067
Phone (847) 701-4273

Organizations & group practices 2

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": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1598438608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 N 1ST BANK DR STE 150",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678102",
            "telephone_number": "312-945-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 N 1ST BANK DR STE 150",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678102",
            "telephone_number": "312-945-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITERSCHAN",
        "first_name": "KARI",
        "middle_name": "ALYSSE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

Verify at the official NPI Registry.