Anthony Crisanti
Individual provider Active NPI Clinical Psychologist · Countryside, IL
NPI 1639636228 · NPPES record last updated Jun 23, 2025
Key facts
- NPI
- 1639636228
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 071.022095 (IL)
- Practice address
- 6502 Joliet Rd Ste 201
Countryside, IL 60525-4682 - Phone
- (708) 215-8400
- NPI assigned
- Mar 1, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.022095 | IL | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.022095 | IL | Yes |
Addresses
Primary practice location
6502 Joliet Rd Ste 201
Countryside, IL 60525-4682
Mailing address
2749 S Hillock Ave
Chicago, IL 60608-5729
Phone (872) 236-6773
Other providers in Countryside, IL
- Eduardo Cortez
- Countryside Dental Group, PC
- Countryside Medical SC
- Countryview Medical Center SC
- Amy M. Cranny
- Catherine Anne Crotty
- Annalyn Cuarteros
- Daniel Curry
- D. Mike Cvetkovic, D.D.S., P.C.
- Jessica Davit
All providers in Countryside, IL · Clinical Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.