Individual provider Active NPI

Thomas Joseph Cahill, PH.D

  • Clinical Psychologist
  • La Grange, IL
National Provider Identifier
1629123849
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0712048 Issued in IL
Practice address
1325 Community Memorial Dr
La Grange, IL 60525-2659
Phone
(708) 245-8940
Fax
(708) 245-5604
NPI assigned
Jan 25, 2007
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0712048 IL Primary
Health Service Psychologist 103TH0100X 0712048 IL

Addresses

Primary practice location

1325 Community Memorial Dr
La Grange, IL 60525-2659

Mailing address

1325 Community Memorial Dr
La Grange, IL 60525-2659
Phone (708) 245-8940

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thomas.cahill.1@380.direct.athenahealth.com

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
I20050303000900 IL Practitioner - Clinical Psychologist 7416901384 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0712048ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Midwest Health CurrentSince Apr 1, 2005 Accepting new patients
Adventist Midwest Health Current Accepting new patients

Locations

5201 Willow Springs Rd
La Grange Highlands, IL 60525
Phone (630) 323-5214

5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073

Organizations & group practices 3

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1629123849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 COMMUNITY MEMORIAL DR",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252659",
            "telephone_number": "708-245-8940",
            "fax_number": "708-245-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 COMMUNITY MEMORIAL DR",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252659",
            "telephone_number": "708-245-8940",
            "fax_number": "708-245-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAHILL",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "0712048",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IL",
            "license": "0712048",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomas.cahill.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1325 Community Memorial Dr",
            "city": "LA Grange",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605252659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Grange, IL

Sources for this page

Verify at the official NPI Registry.