NPIMap

Organization Active NPI

Primary Care Psychology Associates, LLC

  • Psychiatric Hospital Unit
  • Northfield, IL
National Provider Identifier
1790110302
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
071008525 Issued in IL
Legal business name
PRIMARY CARE PSYCHOLOGY ASSOCIATES, LLC
Practice address
465 Central Ave
Suite 201
Northfield, IL 60093-3045
Phone
(847) 686-0090
Fax
(847) 686-0090
NPI assigned
Sep 13, 2013
Last updated
Sep 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Authorized official

Name
Dr. Paul C. Kredow, PSY.D.
Title
Executive Director
Phone
(847) 686-0090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 071008525 IL Primary

Addresses

Primary practice location

465 Central Ave
Suite 201
Northfield, IL 60093-3045

Mailing address

465 Central Ave
Suite 201
Northfield, IL 60093-3045
Phone (847) 686-0090

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Psychology Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1790110302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 CENTRAL AVE",
            "address_2": "SUITE 201",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933045",
            "telephone_number": "847-686-0090",
            "fax_number": "847-686-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 CENTRAL AVE",
            "address_2": "SUITE 201",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933045",
            "telephone_number": "847-686-0090",
            "fax_number": "847-686-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PSYCHOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "KREDOW",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "847-686-0090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IL",
            "license": "071008525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.