NPIMap

Organization Active NPI

Self Improvement Through Awareness PC

Doing business as SITA pc

  • Clinical Psychologist
  • Darien, IL
National Provider Identifier
1649298324
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071005075 Issued in IL
Legal business name
SELF IMPROVEMENT THROUGH AWARENESS PC
Doing business as
SITA pc
Practice address
2628 83Rd St
Darien, IL 60561-1661
Phone
(630) 975-1610
Fax
(630) 246-6809
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Authorized official

Name
Dr. Vijayalakshmi Susarla, PH.D
Title
Clinical Psychologist/President
Phone
(630) 975-1610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 071005075 IL Primary

Addresses

Primary practice location

2628 83Rd St
Darien, IL 60561-1661

Mailing address

632 Conestoga Rd
Naperville, IL 60563-2491
Phone (630) 975-1610

Other names 1

  • SITA pc Doing business as

National Provider Directory

National Provider Directory

Locations

180 N Michigan Ave
Ste 2210
Chicago, IL 60601
Phone (312) 781-1191

2628 83rd St
Darien, IL 60561
Phone (630) 246-6810

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1649298324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 CONESTOGA RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632491",
            "telephone_number": "630-975-1610",
            "fax_number": "630-246-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 83RD ST",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605611661",
            "telephone_number": "630-975-1610",
            "fax_number": "630-246-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF IMPROVEMENT THROUGH AWARENESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "SUSARLA",
        "authorized_official_first_name": "VIJAYALAKSHMI",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/PRESIDENT",
        "authorized_official_telephone_number": "630-975-1610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SITA pc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Darien, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.