Nydia Lelia Welles, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Practice address

4019 Church St
Skokie, IL 60076-1773

Phone

(847) 676-3440

Fax

(847) 676-3486

NPI assigned

May 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nydia Lelia Canovas Welles Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780885772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4019 CHURCH ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761773",
            "telephone_number": "847-676-3440",
            "fax_number": "847-676-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4019 CHURCH ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761773",
            "telephone_number": "847-676-3440",
            "fax_number": "847-676-3486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLES",
        "first_name": "NYDIA",
        "middle_name": "LELIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "01673394",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NYDIA",
            "last_name": "CANOVAS WELLES",
            "middle_name": "LELIA",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Renee Elizabeth Westley, M.D.

• Clinical Psychologist in Skokie, IL
• Providers in Skokie, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.