Active NPI
Angela Dawn McNichols, PSY.D
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1679096572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.009457
- Practice address
- 2800 N Sheridan Rd
Suite 108
Chicago, IL 60640-6064 - Phone
- (773) 344-1995
- NPI assigned
- Jul 23, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.009457 | IL | Primary |
Addresses
Primary practice location
2800 N Sheridan Rd
Suite 108
Chicago, IL 60640-6064
Mailing address
5350 N Glenwood Ave Apt GW
Chicago, IL 60640-2299
Phone (773) 456-1045
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 |
|---|---|---|---|
| 071.009457 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500768000000",
"number": "1679096572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5350 N GLENWOOD AVE APT GW",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606402299",
"telephone_number": "773-456-1045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 N SHERIDAN RD",
"address_2": "SUITE 108",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606406064",
"telephone_number": "773-344-1995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNICHOLS",
"first_name": "ANGELA",
"middle_name": "DAWN",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-23",
"last_updated": "2017-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.009457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.