Active NPI
Robert C Kispert, PH.D
- Marriage & Family Therapist
- Chicago, IL
National Provider Identifier
1679542559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 166.000661
- Practice address
- 30 N Michigan Ave
Suite 1514
Chicago, IL 60602-3402 - Phone
- (312) 629-1907
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 166.000661 | IL | Primary |
Addresses
Primary practice location
30 N Michigan Ave
Suite 1514
Chicago, IL 60602-3402
Mailing address
30 N Michigan Ave
Suite 1514
Chicago, IL 60602-3402
Phone (312) 629-1907
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 166-000661 | Other | IL | MARRIAGE AND FAMILY THERA |
| 35-000718A | Other | IN | MARRIAGE AND FAMILY THERA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 7, 2024 through Jan 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166.000661 | IL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326499200000",
"number": "1679542559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 N MICHIGAN AVE",
"address_2": "SUITE 1514",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606023402",
"telephone_number": "312-629-1907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 N MICHIGAN AVE",
"address_2": "SUITE 1514",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606023402",
"telephone_number": "312-629-1907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISPERT",
"first_name": "ROBERT",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2012-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166.000661",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARRIAGE AND FAMILY THERA",
"identifier": "166-000661",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARRIAGE AND FAMILY THERA",
"identifier": "35-000718A",
"state": "IN"
}
],
"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 Jan 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.