Individual provider Active NPI

Justin Chu, PSYD

  • Clinical Psychologist
  • Schaumburg, IL
National Provider Identifier
1730993999
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-011411 Issued in IL
Practice address
919 N Plum Grove Rd Ste C
Schaumburg, IL 60173-4760
Phone
(847) 413-9700
Fax
(847) 413-1701
NPI assigned
Feb 6, 2025
Last updated
Feb 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-011411 IL Primary

Addresses

Primary practice location

919 N Plum Grove Rd Ste C
Schaumburg, IL 60173-4760

Mailing address

919 N Plum Grove Rd Ste C
Schaumburg, IL 60173-4760
Phone (847) 413-9700

Other practice location 1

1095 Pingree Rd Ste 210
Crystal Lake, IL 60014-1727
Phone (847) 413-9700

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071-011411ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Growth Associates, Inc. CurrentSince Feb 9, 2025 Accepting new patients

Locations

1095 Pingree Rd
Ste 210
Crystal Lake, IL 60014
Phone (847) 413-9700

919 N Plum Grove Rd
Ste C
Schaumburg, IL 60173
Phone (847) 413-9700

Organizations & group practices 1

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": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1730993999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 N PLUM GROVE RD STE C",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734760",
            "telephone_number": "847-413-9700",
            "fax_number": "847-413-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 N PLUM GROVE RD STE C",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734760",
            "telephone_number": "847-413-9700",
            "fax_number": "847-413-1701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1095 Pingree Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600141727",
            "country_code": "US",
            "telephone_number": "847-413-9700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHU",
        "first_name": "JUSTIN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-011411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.