Active NPI
Amanda Linn Weigel-Kuznacic, PSY.D.
- Psychologist
- Glencoe, IL
National Provider Identifier
1659656312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071.008202
- Practice address
- 630 Vernon Ave
Suite G
Glencoe, IL 60022-1681 - Phone
- (847) 835-1770
- NPI assigned
- Oct 13, 2011
- Last updated
- Aug 31, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071.008202 | IL | Primary |
Addresses
Primary practice location
630 Vernon Ave
Suite G
Glencoe, IL 60022-1681
Mailing address
630 Vernon Ave
Suite G
Glencoe, IL 60022-1681
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.008202 | IL | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miriam Fishman, Psy.D., LLC | Past | Accepting new patients | |
| North Suburban Psychological Associates, LTD. | Psychologist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Glencoe, IL
- NPI 1346625472
-
- Psychologist
- Glencoe, IL
- NPI 1932336880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1659656312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 VERNON AVE",
"address_2": "SUITE G",
"city": "GLENCOE",
"state": "IL",
"postal_code": "600221681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 VERNON AVE",
"address_2": "SUITE G",
"city": "GLENCOE",
"state": "IL",
"postal_code": "600221681",
"telephone_number": "847-835-1770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEIGEL-KUZNACIC",
"first_name": "AMANDA",
"middle_name": "LINN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-13",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071.008202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glencoe, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.