Active NPI
Charles E Behrens, PSY.D.
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1740492628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071005216
- Practice address
- 5547 N Ravenswood Ave
Chicago, IL 60640-1125 - Phone
- (773) 769-4313
- Fax
- (773) 769-1179
- NPI assigned
- May 4, 2007
- 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 | 071005216 | IL | Primary |
Addresses
Primary practice location
5547 N Ravenswood Ave
Chicago, IL 60640-1125
Mailing address
7636 N Neva Ave
Niles, IL 60714-4746
Phone (847) 696-9223
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
| License | State | Type | Specialty |
|---|---|---|---|
| 071005216 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432857600000",
"number": "1740492628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7636 N NEVA AVE",
"city": "NILES",
"state": "IL",
"postal_code": "607144746",
"telephone_number": "847-696-9223",
"fax_number": "847-696-9255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5547 N RAVENSWOOD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606401125",
"telephone_number": "773-769-4313",
"fax_number": "773-769-1179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEHRENS",
"first_name": "CHARLES",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2015-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071005216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.