Paul R. Sanders, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071002781 Issued in IL

Practice address

30 N Michigan Ave
Suite 1704
Chicago, IL 60602-3402

Phone

(312) 332-6091

Fax

(312) 332-6508

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1700893237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3647 RADCLIFFE DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624215",
            "telephone_number": "847-302-7682",
            "fax_number": "312-277-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1704",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-332-6091",
            "fax_number": "312-332-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "PAUL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071002781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "0001672882",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX I.D. NUMBER",
            "identifier": "363522880",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "071002781",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lanita Sanders, MSW, LCSW
• Leana Sanders
• Mary Katherine Sanders, LPC
• Michelle Sanders, LSW
• Pamela Lynn Sanders, CDS
• Qiana Jovantay Sanders
• Renita Camille Sanders, FNP
• Renita J Sanders, LCPC
• Rhonda Rudella Sanders, RN
• Rolanda L Sanders, LCSW

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.