Individual provider Active NPI

Anna-Maria J Wegierek-Skorupa, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1770573479
Registry record updated Feb 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071006917 Issued in IL
Practice address
3022 N Harlem Ave #1N
Chicago, IL 60634
Phone
(708) 710-8819
Fax
(773) 745-4545
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 071006917 IL
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 071.006917 IL
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 071.006917 IL
Prescribing (Medical) Psychologist 103TP0016X
Clinical Psychologist 103TC0700X 071006917 IL Primary

Addresses

Primary practice location

3022 N Harlem Ave #1N
Chicago, IL 60634

Mailing address

3022 N Harlem Ave #1N
Chicago, IL 60634
Phone (708) 710-8819

Other practice location 1

7620 W 159th St
Orland Park, IL 60462-5400
Phone (708) 710-8819

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
I20060705000215 IL Practitioner - Clinical Psychologist 1557373818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wegierek Psychology Center, Inc.Group PAC ID 2769494020, 3 clinicians

Practice addresses (Care Compare)

3022 N Harlem Ave
Suite 1N
Chicago, IL 60634-4791
Phone (708) 710-8819

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071006917ILMDCounselor
071.006917ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wegierek Psychology Center, Inc Clinical CurrentSince Mar 1, 2006 Accepting new patients

Locations

3022 N Harlem Ave
Ste 1N
Chicago, IL 60634
Phone (708) 710-8819

7620 W 159th St
Orland Park, IL 60462
Phone (708) 710-8819

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740268800000",
    "number": "1770573479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 N HARLEM AVE #1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60634",
            "telephone_number": "708-710-8819",
            "fax_number": "773-745-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3022 N HARLEM AVE #1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60634",
            "telephone_number": "708-710-8819",
            "fax_number": "773-745-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7620 W 159th St",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604625400",
            "country_code": "US",
            "telephone_number": "708-710-8819",
            "fax_number": "773-745-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEGIEREK-SKORUPA",
        "first_name": "ANNA-MARIA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2025-02-23",
        "certification_date": "2025-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "071006917",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071.006917",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.006917",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.