Active NPI
Javier Antonio Cortez, PSYD
- Clinical Psychologist
- Bloomingdale, IL
National Provider Identifier
1720613045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.009949
- Practice address
- 311 Edgewater Dr
Bloomingdale, IL 60108-1979 - Phone
- (630) 894-7400
- NPI assigned
- Mar 6, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.009949 | IL | Primary |
Addresses
Primary practice location
311 Edgewater Dr
Bloomingdale, IL 60108-1979
Mailing address
126 Main PLZ
San Antonio, TX 78205-2745
Phone (210) 222-2498
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583452800000",
"number": "1720613045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 MAIN PLZ",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782052745",
"telephone_number": "210-222-2498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 EDGEWATER DR",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601081979",
"telephone_number": "630-894-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORTEZ",
"first_name": "JAVIER",
"middle_name": "ANTONIO",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-06",
"last_updated": "2020-03-06",
"certification_date": "2020-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.009949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.