NPIMap

Organization Active NPI

Srodulski Psychological Services, PLLC

  • Clinical Psychologist
  • Rolling Meadows, IL
National Provider Identifier
1649931445
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SRODULSKI PSYCHOLOGICAL SERVICES, PLLC
Practice address
3601 Algonquin Rd Ste 450
Rolling Meadows, IL 60008-3108
Phone
(847) 502-7607
NPI assigned
Jan 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Authorized official

Name
Ann Srodulski, PSYDNPI 1538449673
Title
Clinical Psychologist/Owner
Phone
(847) 502-7607

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3601 Algonquin Rd Ste 450
Rolling Meadows, IL 60008-3108

Mailing address

3035 Wesley Ave
Berwyn, IL 60402-3136
Phone (847) 502-7607

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1649931445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 WESLEY AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023136",
            "telephone_number": "847-502-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 ALGONQUIN RD STE 450",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600083108",
            "telephone_number": "847-502-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRODULSKI PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "SRODULSKI",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "847-502-7607",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Meadows, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.