Individual provider Active NPI

Bradley C. Kahle, PSYD

  • Psychologist
  • Wheaton, IL
National Provider Identifier
1710065412
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
2100 Manchester Rd
Suite 1510
Wheaton, IL 60187-4579
Phone
(630) 653-1717
Fax
(630) 653-1025
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X IL Primary

Addresses

Primary practice location

2100 Manchester Rd
Suite 1510
Wheaton, IL 60187-4579

Mailing address

2100 Manchester Rd
Suite 1510
Wheaton, IL 60187-4579
Phone (630) 653-1717

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
I20130517000275 IL Practitioner - Clinical Psychologist 4284871989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2580 Foxfield Rd
Suite 201
St Charles, IL 60174-1409
Phone (331) 707-4031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-004772ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Meier Clinics of Illinois, P.C. CurrentSince Mar 1, 2013 Accepting new patients
Meier Clinics of Illinois, P.C. Current Accepting new patients
Hessed Psychological Services LLC CurrentSince Feb 17, 2025 Accepting new patients

Locations

2275 Half Day Rd
Ste 350
Bannockburn, IL 60015
Phone (847) 821-2930

2580 Foxfield Rd
Ste 201
St Charles, IL 60174
Phone (331) 707-4031

2100 Manchester Rd
Ste 1510
Wheaton, IL 60187
Phone (708) 653-1717

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710065412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD",
            "address_2": "SUITE 1510",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874579",
            "telephone_number": "630-653-1717",
            "fax_number": "630-653-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD",
            "address_2": "SUITE 1510",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874579",
            "telephone_number": "630-653-1717",
            "fax_number": "630-653-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHLE",
        "first_name": "BRADLEY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.