Individual provider Active NPI

Erinn Kohn, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1770123564
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.010225 Issued in IL
Practice address
4801 W Peterson Ave Ste 601
Chicago, IL 60646-5728
Phone
(847) 329-9210
Fax
(773) 347-2656
NPI assigned
Jan 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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 071.010225 IL Primary

Addresses

Primary practice location

4801 W Peterson Ave Ste 601
Chicago, IL 60646-5728

Mailing address

4801 W Peterson Ave Ste 601
Chicago, IL 60646-5728
Phone (847) 329-9210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230413000161 MI Practitioner - Clinical Psychologist 1153757729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Birmingham Maple ClinicGroup PAC ID 6800867755, 14 clinicians

Practice addresses (Care Compare)

2075 W Big Beaver Rd
Suite 520
Troy, MI 48084-3442
Phone (248) 646-6659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Birmingham Maple Clinic CurrentSince Feb 15, 2023 Accepting new patients

Locations

2075 W Big Beaver Rd
Ste 520
Troy, MI 48084
Phone (248) 646-6659

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": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1770123564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE STE 601",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465728",
            "telephone_number": "847-329-9210",
            "fax_number": "773-347-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE STE 601",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465728",
            "telephone_number": "847-329-9210",
            "fax_number": "773-347-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHN",
        "first_name": "ERINN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.