Faan Yeen Sidor, Psy.D. LTD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

FAAN YEEN SIDOR, PSY.D. LTD

Practice address

175 Olde Half Day Rd Ste 100-7
Lincolnshire, IL 60069-3062

Phone

(847) 431-1722

NPI assigned

Nov 4, 2019

Last updated

Nov 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Faan Yeen Sidor, PSY.D.NPI 1134275282

Title

President

Phone

(847) 431-1722

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Faan Yeen Sidor, PSYD

  • Clinical Psychologist
  • Great Lakes, IL
  • NPI 1134275282
  NPD Authorized official

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572825600000",
    "number": "1720622624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 GREENVIEW PL",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600453222",
            "telephone_number": "847-431-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 OLDE HALF DAY RD STE 100-7",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693062",
            "telephone_number": "847-431-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAAN YEEN SIDOR, PSY.D. LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A",
        "authorized_official_last_name": "SIDOR",
        "authorized_official_first_name": "FAAN YEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-431-1722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.