Active NPI
Stefan Elliot Latulip, PH.D.
- Clinical Neuropsychologist
- Oak Brook, IL
National Provider Identifier
1760101125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 071010810
- Practice address
- 2021 Midwest Rd Ste 104
Oak Brook, IL 60523-1396 - Phone
- (630) 280-8173
- NPI assigned
- Aug 26, 2022
- 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 Neuropsychologist | 103G00000X | 071010810 | IL | Primary |
Addresses
Primary practice location
2021 Midwest Rd Ste 104
Oak Brook, IL 60523-1396
Mailing address
2021 Midwest Rd Ste 104
Oak Brook, IL 60523-1396
Phone (630) 280-8173
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2021 Midwest Rd
Suite 104
Oak Brook, IL 60523-1396
Phone (630) 280-8173
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071010810 | IL | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anthony Tucci PHD LLC | Clinical Neuropsychologist | Current | Accepting new patients |
Locations
2021 Midwest Rd
Ste 104
Oak Brook, IL 60523
Phone (630) 280-8173
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661472000000",
"number": "1760101125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2021 MIDWEST RD STE 104",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231396",
"telephone_number": "630-280-8173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2021 MIDWEST RD STE 104",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231396",
"telephone_number": "630-280-8173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATULIP",
"first_name": "STEFAN",
"middle_name": "ELLIOT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-26",
"last_updated": "2022-08-26",
"certification_date": "2022-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "IL",
"license": "071010810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Brook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.