Joan Eileen Funk, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

655 Landwehr Rd
Northbrook, IL 60062-2311

Phone

(847) 498-1699

Fax

(847) 239-6029

NPI assigned

Feb 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Philip J Metres Jr, PH.D.,P.C.

  • Clinical Psychologist
  • Lincolnshire, IL
  • NPI 1568728061
  NPD (past)

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740324128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 LANDWEHR RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622311",
            "telephone_number": "847-498-1699",
            "fax_number": "847-239-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 LANDWEHR RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622311",
            "telephone_number": "847-498-1699",
            "fax_number": "847-239-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "JOAN",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD , IL",
            "identifier": "01632155",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fuel Physical Therapy and Wellness
• Full Life Rejuvenation
• Lauren Fulton, LCSW
• Functional Medical Wellness Center , LLC
• Anna Katerina Funk
• Elizabeth Fyfe, M.S. CCC-SLP
• Gaf/Lake Cook Terrace
• Joel Galiotto
• Tammy Louise Galizia, DPM
• Marie Ann Calayag Gallano

• Psychologist in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.