Individual provider Active NPI

Julie Lynn Ruddy, PSY.D.

  • Clinical Psychologist
  • Great Lakes, IL
National Provider Identifier
1740251214
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
3420 Illinois St
Recruit Mental Health, Uss Tranquillity
Great Lakes, IL 60088-3120
Phone
(847) 688-7406
Fax
(847) 688-7403
NPI assigned
Jan 31, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 IL Primary

Addresses

Primary practice location

3420 Illinois St
Recruit Mental Health, Uss Tranquillity
Great Lakes, IL 60088-3120

Mailing address

3420 Illinois St
Recruit Mental Health, Uss Tranquillity
Great Lakes, IL 60088-3120
Phone (847) 688-7406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-006056ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Uss Tranq - Turn Two Phcy Past Accepting new patients

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1740251214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 ILLINOIS ST",
            "address_2": "RECRUIT MENTAL HEALTH, USS TRANQUILLITY",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600883120",
            "telephone_number": "847-688-7406",
            "fax_number": "847-688-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 ILLINOIS ST",
            "address_2": "RECRUIT MENTAL HEALTH, USS TRANQUILLITY",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600883120",
            "telephone_number": "847-688-7406",
            "fax_number": "847-688-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDY",
        "first_name": "JULIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Lakes, IL

Sources for this page

Verify at the official NPI Registry.