Organization Active NPI

Stephanie a Ross Licensed Clinical Psychologist PC

  • Clinical Psychologist
  • Glenview, IL
National Provider Identifier
1760516660
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
STEPHANIE A ROSS LICENSED CLINICAL PSYCHOLOGIST PC
Practice address
3633 W Lake Ave
Suite 400
Glenview, IL 60026-5805
Phone
(773) 459-6756
Fax
(773) 728-8719
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephanie A Ross, PHD
Title
Owned
Phone
(773) 459-6756

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X IL Primary

Addresses

Primary practice location

3633 W Lake Ave
Suite 400
Glenview, IL 60026-5805

Mailing address

3633 W Lake Ave
Suite 400
Glenview, IL 60026-5805
Phone (773) 459-6756

Other names 1

  • Stephanie A Ross Licensed Clinical Psychologist PC Former legal business name

National Provider Directory

National Provider Directory

Locations

233 E Erie St
Ste 300
Chicago, IL 60611
Phone (773) 459-6756

3633 W Lake Ave
Ste 400
Glenview, IL 60026
Phone (773) 459-6756

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760516660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE 400",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265805",
            "telephone_number": "773-459-6756",
            "fax_number": "773-728-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE 400",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265805",
            "telephone_number": "773-459-6756",
            "fax_number": "773-728-8719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE A ROSS LICENSED CLINICAL PSYCHOLOGIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNED",
        "authorized_official_telephone_number": "773-459-6756",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stephanie A Ross Licensed Clinical Psychologist PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.