Individual provider Active NPI

Tamar D Gefen, PHD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1770903353
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.009672 Issued in IL
Practice address
676 N Saint Clair St
Chicago, IL 60611-2927
Phone
(312) 908-9339
NPI assigned
Apr 22, 2014
Last updated
Dec 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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 071.009672 IL Primary

Addresses

Primary practice location

676 N Saint Clair St
Chicago, IL 60611-2927

Mailing address

320 E Superior St
Searle, 11
Chicago, IL 60611-3010
Phone (312) 503-5206

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
I20180125002384 IL Practitioner - Clinical Psychologist 9436418183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

676 N Saint Clair
Chicago, IL 60611-2927

676 N Saint Clair St
Chicago, IL 60611-2927

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071.009672ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Mar 15, 2018 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 15, 2018 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

676 N Saint Clair St
Chicago, IL 60611
Phone (312) 926-6895

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 2

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": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1770903353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E SUPERIOR ST",
            "address_2": "SEARLE, 11",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113010",
            "telephone_number": "312-503-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112927",
            "telephone_number": "312-908-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEFEN",
        "first_name": "TAMAR",
        "middle_name": "D",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.