Individual provider Active NPI

Michael J Tansey, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1629199567
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-002506 Issued in IL
Practice address
151 N Michigan Ave
Suite 2119
Chicago, IL 60601-7506
Phone
(312) 729-5225
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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 071-002506 IL Primary

Addresses

Primary practice location

151 N Michigan Ave
Suite 2119
Chicago, IL 60601-7506

Mailing address

151 N Michigan Ave
Suite 2119
Chicago, IL 60601-7506
Phone (312) 729-5225

Other identifiers 2

IdentifierTypeStateIssuer
071-002506OtherILSTATE LICENSE
36-3173071OtherILTAX ID

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
I20070606000020 IL Practitioner - Clinical Psychologist 9739287350 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1723 N Dayton St
Chicago, IL 60614-5511
Phone (312) 560-1353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071-002506ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1629199567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N MICHIGAN AVE",
            "address_2": "SUITE 2119",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017506",
            "telephone_number": "312-729-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N MICHIGAN AVE",
            "address_2": "SUITE 2119",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017506",
            "telephone_number": "312-729-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANSEY",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-002506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "071-002506",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "36-3173071",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.