Angela Katherine Picot Derrick, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-007116 Issued in IL

Practice address

53 W Jackson Blvd Ste 520
Chicago, IL 60604-3433

Phone

(773) 578-7406

NPI assigned

Apr 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Springsource Psychological Center PLLCGroup PAC ID 6901381490, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Springsource Psychological Center PLLC

  • Adult Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1033735550

  Clinical

  Medicare reassignment Care Compare group NPD
• Springsource Psychological Center PLLC

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1447192422
  NPD

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1659599009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W IRVING PARK RD",
            "address_2": "#2317",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133123",
            "telephone_number": "773-578-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD STE 520",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043433",
            "telephone_number": "773-578-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICOT DERRICK",
        "first_name": "ANGELA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-007116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pickup & Dropoff Transportation
• Pickup Transport LLLP
• Chantal Pico, MA
• Jessica Marie Picone, RD
• Raymundo Picos, MD
• Piece of Nutrition, LLC
• Nicholas J Piechotte, LCSW, MSW, CADC
• Brian Piechowski, M.D.
• Steven R Piecyk, PHARMD
• Kasia Pieczara, LSW

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.