Individual provider Active NPI

Svetlana Medvedeva, PSYD/HSPP

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1639542368
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009391 Issued in IL
Practice address
1011 W Wellington Ave Ste 210
Chicago, IL 60657-7187
Phone
(312) 384-1940
NPI assigned
Nov 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071009391 IL Primary
Professional Counselor 101YP2500X 178007918 IL

Addresses

Primary practice location

1011 W Wellington Ave Ste 210
Chicago, IL 60657-7187

Mailing address

1011 W Wellington Ave Ste 210
Chicago, IL 60657-7187
Phone (312) 384-1940

Other practice location 1

747 N La Salle Dr Ste 700
Chicago, IL 60654-5089
Phone (312) 384-1940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160310000978 IN Practitioner - Clinical Psychologist 0446556807 Reassigns benefits to 1 organization
I20230911001137 IL Practitioner - Clinical Psychologist 0446556807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

2845 N Sheridan Rd
Suite 809
Chicago, IL 60657-7227
Phone (888) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178007918ILMDProfessional Counselor
071009391ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. CurrentSince Aug 7, 2023 Accepting new patients
Southlake Community Mental Health Center Inc. CurrentSince Feb 7, 2016 Accepting new patients
Psychology Specialists LTD Clinical Past Accepting new patients
Edgewood Clinical Services, P.C. Past Accepting new patients

Locations

808 S Eldorado Rd
Ste 300
Bloomington, IL 61704
Phone (309) 827-2962

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

2845 N Sheridan Rd
Ste 809
Chicago, IL 60657
Phone (312) 761-4721

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

1010 Lake St
Ste 110
Oak Park, IL 60301
Phone (331) 529-7413

15303 S 94th Ave
Ste 250
Orland Park, IL 60462
Phone (708) 505-5205

175 E Hawthorne Pkwy
Ste 235
Vernon Hills, IL 60061
Phone (847) 865-4125

3903 Indianapolis Blvd
East Chicago, IN 46312
Phone (219) 392-6001

5900 Hohman Ave
Hammond, IN 46320
Phone (219) 931-0427

8555 Taft St
Merrillville, IN 46410
Phone (219) 736-7232

8400 Louisiana St
Merrillville, IN 46410
Phone (219) 757-1924

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": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1639542368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W WELLINGTON AVE STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577187",
            "telephone_number": "312-384-1940",
            "fax_number": "773-423-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W WELLINGTON AVE STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577187",
            "telephone_number": "312-384-1940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 N La Salle Dr Ste 700",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606545089",
            "country_code": "US",
            "telephone_number": "312-384-1940",
            "fax_number": "773-423-8444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDVEDEVA",
        "first_name": "SVETLANA",
        "credential": "PSYD/HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009391",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178007918",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.