Adam Fominaya, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071010432 Issued in IL

Practice address

6301 N Sheridan Rd Apt 23K
Chicago, IL 60660-5701

Phone

(815) 579-6222

NPI assigned

Jul 20, 2020

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Delve Psychotherapy of Chicago

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1790371847
  NPD Authorized official

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678579200000",
    "number": "1760090385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 N SHERIDAN RD APT 23K",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606605701",
            "telephone_number": "815-579-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 N SHERIDAN RD APT 23K",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606605701",
            "telephone_number": "815-579-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMINAYA",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-20",
        "last_updated": "2023-03-12",
        "certification_date": "2023-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071010432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Janeen Foltz Hottle, M.A., CCC-SLP
• Phoebe A. Foltz
• Christine Folz, MS, OTR/L
• Victoria Katherine Fombelle, LPC
• Fomeak Inc
• Larissa Fomum Mugri, MD
• Tracy Fondren-Lusk
• Brian Fondren, FNP-C
• Nia Denise Foney
• Michal Fonfa, SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2023; 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.