Individual provider Active NPI

Sharon Z Johnson, PH.D.

  • Clinical Neuropsychologist
  • Glenview, IL
National Provider Identifier
1760664098
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
071006756 Issued in IL
Practice address
3633 W Lake Ave
Suite 406
Glenview, IL 60026-5805
Phone
(847) 657-9885
Fax
(847) 657-9815
NPI assigned
Nov 28, 2007
Last updated
Jun 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 071006756 IL Primary

Addresses

Primary practice location

3633 W Lake Ave
Suite 406
Glenview, IL 60026-5805

Mailing address

3633 W Lake Ave
Suite 406
Glenview, IL 60026-5805
Phone (847) 657-9885

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071006756ILMDClinical Neuropsychologist

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.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1760664098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE 406",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265805",
            "telephone_number": "847-657-9885",
            "fax_number": "847-657-9815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE 406",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265805",
            "telephone_number": "847-657-9885",
            "fax_number": "847-657-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHARON",
        "middle_name": "Z",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071006756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 7, 2011; 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.