John Hardie PHD Clinical Psychologist LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

JOHN HARDIE PHD CLINICAL PSYCHOLOGIST LLC

Practice address

85 Revere Dr Ste G
Northbrook, IL 60062-8001

Phone

(847) 559-9343

Fax

(773) 913-2395

NPI assigned

Jul 6, 2021

Organization subpart

No

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

Authorized official

Name

Yesenia Servin, CPMSM, PESC

Title

Credentialing Mananger

Phone

(708) 979-9082

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• John Christian Hardie, PH.D.

  • Psychologist
  • Chicago, IL
  • NPI 1376732255
  NPD

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1629649157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 REVERE DR STE G",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628001",
            "telephone_number": "847-559-9343",
            "fax_number": "773-913-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 REVERE DR STE G",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628001",
            "telephone_number": "847-559-9343",
            "fax_number": "773-913-2395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 N Sheridan Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606576183",
            "country_code": "US",
            "telephone_number": "847-559-9343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOHN HARDIE PHD CLINICAL PSYCHOLOGIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "SERVIN",
        "authorized_official_first_name": "YESENIA",
        "authorized_official_title_or_position": "CREDENTIALING MANANGER",
        "authorized_official_telephone_number": "708-979-9082",
        "authorized_official_credential": "CPMSM, PESC"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zahra Jiwani, RN, FNP-BC
• JKL in-Home Care, LLC
• Joanna E Lindell DO LLC
• Joel M Groner Psy D PC
• Julian M Joffe, M.D.
• Rebecca John
• Erica Johnson, BCBA
• Flynn Mary Johnson, M.S., LMFT
• Jaclyn Stillmaker Johnson, MOT, OTR/L
• Kelly Marie Johnson, FNP-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.