Patricia Johnson, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009009 Issued in IL

Practice address

1122 Westgate St
Oak Park, IL 60301

Phone

(708) 228-9492

NPI assigned

Nov 24, 2008

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

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Davken Associates, P.C.

  • Clinical Psychologist
  • Deerfield, IL
  • NPI 1457393159
  Medicare reassignment NPD
• Lawndale Christian Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1245289214
  Medicare reassignment NPD
• Nia Integrative Healing

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Park, IL
  • NPI 1063981207
  NPD Authorized official
• Lawndale Christian Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1154598282
  NPD
• Lawndale Christian Health Center

  • Health Educator
  • Chicago, IL
  • NPI 1588537641
  NPD
• Lawndale Christian Health Center

  • Community/Retail Pharmacy
  • Chicago, IL
  • NPI 1679680235
  NPD

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1750536223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1038 S CUYLER AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603042202",
            "telephone_number": "708-228-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 WESTGATE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "60301",
            "telephone_number": "708-228-9492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 S Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603022905",
            "country_code": "US",
            "telephone_number": "708-228-9492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1122 Westgate St",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "60301",
            "country_code": "US",
            "telephone_number": "708-228-9492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick James Johnson, PSY.D
• Kenya Johnson
• Lauren Johnson
• Marjorie Johnson
• Maryann Johnson, REGISTERED NURSE
• Samiya Johnson
• Sara Beth Johnson, M.S.W., L.C.S.W, PHD
• Charles Bradford Johnston, MD
• Janis Clark Johnston, ED.D.
• Helen Ann Jonas, MA

• Clinical Psychologist in Oak Park, IL
• Providers in Oak Park, 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 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.