Keith V Bjorge, PSY D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-005483 Issued in IL

Practice address

61 S Old Rand Rd
Lake Zurich, IL 60047-3127

Phone

(847) 438-4222

NPI assigned

May 13, 2008

Last updated

May 13, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cherry Hill Associates, LLCGroup PAC ID 1557523552, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Cherry Hill Associates, LLC

  dba Cherry Hill Center

  • Clinical Social Worker
  • Lake Zurich, IL
  • NPI 1225277668
  Medicare reassignment Care Compare group NPD
• Keith V Bjorge PSYD PC

  dba Crossroads

  • Clinical Psychologist
  • Lake Zurich, IL
  • NPI 1790854636
  Authorized official Same address or phone

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1700053360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 S OLD RAND RD",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600473127",
            "telephone_number": "847-438-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 S OLD RAND RD",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600473127",
            "telephone_number": "847-438-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJORGE",
        "first_name": "KEITH",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Better Body Boot Camp Inc (DS Medical Supply)
• Raymond Samuel Bianchi, M.D.
• Katrina Bielanski, MS SLP
• Beth Anne Binder
• Bessy Binkowski, R.PH.
• Roger Blank, O.D.
• Mary R Block, M.S., O.T.R.
• Amanda Blucher, LSW
• Mariya Blue, MSW, LCSW
• Paul R Bohn, RPH

• Clinical Psychologist in Lake Zurich, IL
• Providers in Lake Zurich, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.