Individual provider Active NPI

Ruth M Rattenbury, PSY.D.

  • Clinical Psychologist
  • Evanston, IL
National Provider Identifier
1609910264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
600 Davis St
Suite 3E
Evanston, IL 60201-4488
Phone
(847) 644-3284
Fax
(847) 328-4838
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

600 Davis St
Suite 3E
Evanston, IL 60201-4488

Mailing address

2711 W Greenleaf Ave
Chicago, IL 60645-3013
Phone (773) 262-5099

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
I20070525000131 IL Practitioner - Clinical Psychologist 3476650490 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-004517ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ruth M Rattenbury Psy D PC Clinical CurrentSince May 25, 2007 Accepting new patients

Locations

600 Davis St
Ste 3E
Evanston, IL 60201
Phone (847) 424-1241

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609910264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 W GREENLEAF AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606453013",
            "telephone_number": "773-262-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DAVIS ST",
            "address_2": "SUITE 3E",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014488",
            "telephone_number": "847-644-3284",
            "fax_number": "847-328-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATTENBURY",
        "first_name": "RUTH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.