Individual provider Active NPI

Annette Arzt, PH.D.

  • Clinical Psychologist
  • Des Plaines, IL
National Provider Identifier
1649454463
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
960 Rand Rd
219-A
Des Plaines, IL 60016-2352
Phone
(847) 824-2686
Fax
(847) 838-5958
NPI assigned
Dec 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 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

960 Rand Rd
219-A
Des Plaines, IL 60016-2352

Mailing address

960 Rand Rd
219-A
Des Plaines, IL 60016-2352
Phone (847) 824-2686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080119000113 IL Practitioner - Clinical Psychologist 5294816997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

95 W Grand Ave
Suite 110
Lake Villa, IL 60046-8639
Phone (847) 356-3100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Annette Arzt SC Clinical CurrentSince Jan 19, 2008 Accepting new patients

Locations

960 Rand Rd
Ste 219A
Des Plaines, IL 60016
Phone (847) 824-2686

95 W Grand Ave
Ste 110
Lake Villa, IL 60046
Phone (847) 356-3100

Organizations & group practices 1

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": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198800000000",
    "number": "1649454463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 RAND RD",
            "address_2": "219-A",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162352",
            "telephone_number": "847-824-2686",
            "fax_number": "847-838-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 RAND RD",
            "address_2": "219-A",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162352",
            "telephone_number": "847-824-2686",
            "fax_number": "847-838-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARZT",
        "first_name": "ANNETTE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.