Active NPI
Christopher Burgess, PSY.D.
- Psychologist
- Chicago, IL
National Provider Identifier
1679902324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071.009184
- Practice address
- 1554 W Hollywood
#Storefront
Chicago, IL 60660 - Phone
- (773) 673-9233
- NPI assigned
- Nov 4, 2013
- Last updated
- Dec 1, 2019
- Sex
- Male
- 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 | 071.009184 | IL | Primary |
Addresses
Primary practice location
1554 W Hollywood
#Storefront
Chicago, IL 60660
Mailing address
1554 W Hollywood
#Storefront
Chicago, IL 60660-4399
Phone (773) 673-9233
Other practice location 1
5315 N Clark St # 180
Chicago, IL 60640-2290
Phone (773) 673-9233
Other practice location 2
611 W Roosevelt Rd
Chicago, IL 60607-4911
Phone (773) 570-3382
Other practice location 3
1554 W Hollywood
#Storefront
Chicago, IL 60660
Phone (773) 673-9233
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.009184 | IL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575158400000",
"number": "1679902324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1554 W HOLLYWOOD",
"address_2": "#STOREFRONT",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606604399",
"telephone_number": "773-673-9233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1554 W HOLLYWOOD",
"address_2": "#STOREFRONT",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60660",
"telephone_number": "773-673-9233"
}
],
"practiceLocations": [
{
"address_1": "5315 N Clark St # 180",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606402290",
"country_code": "US",
"telephone_number": "773-673-9233",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "611 W Roosevelt Rd",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606074911",
"country_code": "US",
"telephone_number": "773-570-3382",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1554 W Hollywood",
"address_2": "#Storefront",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "60660",
"country_code": "US",
"telephone_number": "773-673-9233",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURGESS",
"first_name": "CHRISTOPHER",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-04",
"last_updated": "2019-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071.009184",
"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 Dec 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.