Individual provider Active NPI

Logan Stohle

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1689198251
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.010503 Issued in IL
Practice address
2352 W Shakespeare Ave Unit 2a
Chicago, IL 60647-6464
Phone
(847) 636-9528
NPI assigned
Jul 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.010503 IL Primary

Addresses

Primary practice location

2352 W Shakespeare Ave Unit 2a
Chicago, IL 60647-6464

Mailing address

2352 W Shakespeare Ave Unit 2a
Chicago, IL 60647-6464
Phone (847) 636-9528

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

LicenseStateTypeSpecialty
071.010503ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Logan Stohle, LLC Clinical CurrentSince Nov 19, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1689198251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 W SHAKESPEARE AVE UNIT 2A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606476464",
            "telephone_number": "847-636-9528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2352 W SHAKESPEARE AVE UNIT 2A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606476464",
            "telephone_number": "847-636-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOHLE",
        "first_name": "LOGAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010503",
            "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 May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.