Individual provider Active NPI

Saul Howard Chapman, PH.D.

  • Clinical Neuropsychologist
  • Carbondale, IL
National Provider Identifier
1760548218
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
3200 Fishback Road
Milwood Executive Suites
Carbondale, IL 62901-6307
Phone
(618) 549-5043
Fax
(618) 351-1419
NPI assigned
Dec 29, 2006
Last updated
Oct 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X IL Primary
Clinical Neuropsychologist 103G00000X 0152091 NY
Psychologist 103T00000X 07006462 IL
Psychologist 103T00000X 0152091 NY

Addresses

Primary practice location

3200 Fishback Road
Milwood Executive Suites
Carbondale, IL 62901-6307

Mailing address

1008 W Laurel St
Carbondale, IL 62901-1154
Phone (618) 549-5043

Other identifiers 1

IdentifierTypeStateIssuer
3932031OtherILBCBSIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07006462ILMDPsychologist
0152091NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1760548218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 W LAUREL ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011154",
            "telephone_number": "618-549-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 FISHBACK ROAD",
            "address_2": "MILWOOD EXECUTIVE SUITES",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629016307",
            "telephone_number": "618-549-5043",
            "fax_number": "618-351-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "SAUL",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "0152091",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "07006462",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "0152091",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "3932031",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.