Individual provider Active NPI

Ellen Somberg, PSY.D.

  • Clinical Psychologist
  • Oak Park, IL
National Provider Identifier
1619939865
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
71-4307 Issued in IL
Practice address
1100 Lake St
Oak Park, IL 60301-1015
Phone
(312) 346-1354
NPI assigned
Apr 4, 2006
Last updated
Sep 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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 71-4307 IL Primary

Addresses

Primary practice location

1100 Lake St
Oak Park, IL 60301-1015

Mailing address

747 Belleforte Ave
Oak Park, IL 60302-1580
Phone (708) 524-8631

Other identifiers 1

IdentifierTypeStateIssuer
0001605401OtherILBCBS ID NUMBER

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
I20071129000073 IL Practitioner - Clinical Psychologist 9931298981 Practice locations: Chicago, IL; Oak Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 N Michigan Ave
Suite 506
Chicago, IL 60602-3837
Phone (312) 346-1354

747 Belleforte Ave
Oak Park, IL 60302-1580
Phone (312) 346-1354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71-4307ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1619939865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 BELLEFORTE AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021580",
            "telephone_number": "708-524-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011015",
            "telephone_number": "312-346-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMBERG",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "71-4307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID NUMBER",
            "identifier": "0001605401",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.