Individual provider Active NPI

Christina Souv Khou, PHD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1700449659
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-010318 Issued in IL
Practice address
1645 W Jackson Blvd Ste 400
Chicago, IL 60612-3244
Phone
(312) 942-5932
Fax
(312) 942-4990
NPI assigned
Apr 16, 2019
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071010318 IL
Health Psychologist 103TH0004X
Clinical Psychologist 103TC0700X 071-010318 IL Primary

Addresses

Primary practice location

1645 W Jackson Blvd Ste 400
Chicago, IL 60612-3244

Mailing address

1645 W Jackson Blvd Ste 400
Chicago, IL 60612-3244
Phone (312) 942-5932

Other names 1

  • Christina Khou Other name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201121000035 IL Practitioner - Clinical Psychologist 3577974690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Kansas School of Med (KC/Wich/Sal), 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1620 W Harrison St
Chicago, IL 60612-3801

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

516 S Loomis St
Chicago, IL 60607-2812
Phone (312) 942-5000

710 S Paulina St
Chicago, IL 60612-3808

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-010318ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Clinical CurrentSince Nov 1, 2020 Accepting new patients
Rush University Medical Center CurrentSince Nov 1, 2020 Accepting new patients

Locations

1645 W Jackson Blvd
Ste 400
Chicago, IL 60612
Phone (312) 942-5932

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 263
Chicago, IL 60612
Phone (312) 942-6163

1750 W Harrison St
#310
Chicago, IL 60612
Phone (312) 942-5932

710 S Paulina St
Ste 732
Chicago, IL 60612
Phone (312) 942-5661

75 Remittance Dr
Dept 1611
Chicago, IL 60675

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1700449659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123244",
            "telephone_number": "312-942-5932",
            "fax_number": "312-942-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123244",
            "telephone_number": "312-942-5932",
            "fax_number": "312-942-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOU",
        "first_name": "CHRISTINA",
        "middle_name": "SOUV",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071010318",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-010318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "KHOU",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.