Robert Edwin Porter III, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.011347 Issued in IL

Practice address

1200 Harger Rd Ste 600
Oak Brook, IL 60523-1820

Phone

(901) 734-6460

NPI assigned

Dec 16, 2024

Last updated

Dec 16, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1710794425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HARGER RD STE 600",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231820",
            "telephone_number": "901-734-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HARGER RD STE 600",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231820",
            "telephone_number": "901-734-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "ROBERT",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.011347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Pollard, LCSW
• Katarina Nicole Pong, DPT
• Subhash Popli, MD
• Teresa J Poprawski, M.D.
• Joseph John Porada Jr., M.D.
• Neelima Devi Prabhala, MA, LCSW
• Precious Home Care LLC
• Premier Gi PLLC
• Ketrina Premti, M.A., LPC
• Antoinette Lee Priester, LCSW

• Clinical Psychologist in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.