Jon-Paul Champine, Psy.D., P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006739 Issued in IL

Legal business name

JON-PAUL CHAMPINE, PSY.D., P.C.

Practice address

2530 Crawford Ave
Suite 315
Evanston, IL 60201-4970

Phone

(847) 869-4650

Fax

(773) 751-2250

NPI assigned

Mar 26, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jon-Paul Champine, PSYDNPI 1982698833

Title

President

Phone

(847) 869-4650

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jon-Paul Champine, PSY.D.

  • Clinical Psychologist
  • Kenilworth, IL
  • NPI 1982698833
  Medicare reassignment NPD Authorized official
• James Dale McHolland, PHD

  • Clinical Psychologist
  • Evanston, IL
  • NPI 1114000841
  NPD (past)

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

{
    "created_epoch": "1301097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301097600000",
    "number": "1629377882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE",
            "address_2": "SUITE 315",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014970",
            "telephone_number": "847-869-4650",
            "fax_number": "773-751-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE",
            "address_2": "SUITE 315",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014970",
            "telephone_number": "847-869-4650",
            "fax_number": "773-751-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON-PAUL CHAMPINE, PSY.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-26",
        "last_updated": "2011-03-26",
        "status": "A",
        "authorized_official_last_name": "CHAMPINE",
        "authorized_official_first_name": "JON-PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-869-4650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael A Johnson, D,D,S
• Neal Johnson, DNP, CRNA
• Rebecca A Johnson, OTR/L
• Samantha Johnson, APN
• Tamara Antionette Johnson, PH.D.
• Amanda Jones, LSW, JD
• Blake Anthony Jones, M.D.
• Caroline Young Jones, MD
• Colette Jones, MA, LPC, NCC
• Courtney Jones, MS, ATC, CSCS

• Clinical Psychologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.