Individual provider Active NPI

Melissa Ann Cinquegrani-Pence, PSY.D.

  • Clinical Psychologist
  • Bloomingdale, IL
National Provider Identifier
1629409651
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.008699 Issued in IL
Practice address
1 Tiffany PT
#105
Bloomingdale, IL 60108-2936
Phone
(630) 980-1400
NPI assigned
Dec 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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 071.008699 IL Primary

Addresses

Primary practice location

1 Tiffany PT
#105
Bloomingdale, IL 60108-2936

Mailing address

1 Tiffany PT
#105
Bloomingdale, IL 60108-2936
Phone (630) 980-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.008699ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pride Medical Equipment LLC CurrentSince Feb 14, 2021 Accepting new patients
Dr. Melissa Cinquegrani LLC Clinical Current Accepting new patients
Bhes Medical Group, LLC Clinical PastSince Jan 1, 2015 Accepting new patients
Center for Integrative and Functional Health and Wellness LLC PastSince Nov 10, 2022 Accepting new patients

Locations

17W727 Butterfield Rd
Ste G
Oakbrook Terrace, IL 60181
Phone (630) 629-3015

Organizations & group practices 4

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": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1629409651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT",
            "address_2": "#105",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082936",
            "telephone_number": "630-980-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT",
            "address_2": "#105",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082936",
            "telephone_number": "630-980-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CINQUEGRANI-PENCE",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.