Individual provider Active NPI

Matthew Galloucis, PH.D.

  • Clinical Psychologist
  • Palatine, IL
National Provider Identifier
1760454755
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071005449 Issued in IL
Practice address
909 E Palatine Rd
Palatine, IL 60074-5551
Phone
(847) 776-1400
Fax
(847) 776-1864
NPI assigned
Feb 3, 2006
Last updated
Mar 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071005449 IL Primary

Addresses

Primary practice location

909 E Palatine Rd
Palatine, IL 60074-5551

Mailing address

909 E Palatine Rd
Palatine, IL 60074-5551
Phone (847) 776-1400

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000770 IL Practitioner - Clinical Psychologist 7517986920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Loyola University of Chicago, Stritch School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Associates of the Midwest, S.C.Group PAC ID 4880597020, 10 clinicians

Practice addresses (Care Compare)

909 E Palatine Rd
Palatine, IL 60074-5551
Phone (847) 776-1400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
100
Improvement activities
40
Cost
55.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071005449ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates of the Midwest, S.C. Clinical CurrentSince Jan 1, 2006 Accepting new patients

Locations

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

1201 American Way
Libertyville, IL 60048
Phone (847) 371-6500

850 E US Highway 45
Mundelein, IL 60060
Phone (224) 864-7400

909 E Palatine Rd
Palatine, IL 60074
Phone (847) 776-1400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1760454755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 E PALATINE RD",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600745551",
            "telephone_number": "847-776-1400",
            "fax_number": "847-776-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E PALATINE RD",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600745551",
            "telephone_number": "847-776-1400",
            "fax_number": "847-776-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLOUCIS",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

Verify at the official NPI Registry.