Individual provider Active NPI

Desiree Anne Wilkinson, PHD

  • Cognitive & Behavioral Psychologist
  • Chicago, IL
National Provider Identifier
1669030672
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
071.009322 Issued in IL
Practice address
5113 S Harper Ave Ste 2C
Chicago, IL 60615-4119
Phone
(859) 227-9796
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 071.009322 IL Primary

Addresses

Primary practice location

5113 S Harper Ave Ste 2C
Chicago, IL 60615-4119

Mailing address

1134 S Taylor Ave
Oak Park, IL 60304-2231
Phone (859) 227-9796

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwilkinson@anchorcbt.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 7, 2017 through Jul 7, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.009322ILMDCognitive & Behavioral Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1669030672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 S TAYLOR AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603042231",
            "telephone_number": "859-227-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 S HARPER AVE STE 2C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154119",
            "telephone_number": "859-227-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "DESIREE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IL",
            "license": "071.009322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwilkinson@anchorcbt.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5113 S Harper Ave Ste 2C",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606154119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.