Individual provider Active NPI

Ellen Fay Geddes, PSYD.

  • Psychologist
  • Palos Heights, IL
National Provider Identifier
1629997051
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071.022710 Issued in IL
Practice address
11800 S 75TH Ave FL 3
Palos Heights, IL 60463-1033
Phone
(708) 726-6472
NPI assigned
Jul 10, 2026
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.022710 IL Primary

Addresses

Primary practice location

11800 S 75TH Ave FL 3
Palos Heights, IL 60463-1033

Mailing address

2736 N Hampden CT Apt 201
Chicago, IL 60614-1635
Phone (480) 980-3730

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Miracare Neuro Behavioral Health, PC Psychologist Past Accepting new patients

Organizations & group practices 2

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": "1783641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1629997051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2736 N HAMPDEN CT APT 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141635",
            "telephone_number": "480-980-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 S 75TH AVE FL 3",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631033",
            "telephone_number": "708-726-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDDES",
        "first_name": "ELLEN",
        "middle_name": "FAY",
        "credential": "PSYD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-10",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.022710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.