Individual provider Active NPI

Maureen R Ford, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1639239429
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
180 N Michigan Ave
Ste 2200
Chicago, IL 60601-7401
Phone
(312) 425-0150
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

180 N Michigan Ave
Ste 2200
Chicago, IL 60601-7401

Mailing address

180 N Michigan Ave
Ste 2200
Chicago, IL 60601-7401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 15, 2023 through Nov 15, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071-003720ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639239429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "STE 2200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "STE 2200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017401",
            "telephone_number": "312-425-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "MAUREEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.