Individual provider Active NPI

John E Mayer, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1790816841
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-02554 Issued in IL
Practice address
55 E Washington St
38TH Floor
Chicago, IL 60602-2103
Phone
(312) 917-1240
Fax
(312) 917-1010
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 071-02554 IL Primary

Addresses

Primary practice location

55 E Washington St
38TH Floor
Chicago, IL 60602-2103

Mailing address

55 E Washington St
38TH Floor
Chicago, IL 60602-2103
Phone (312) 917-1240

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
I20060201000721 IL Practitioner - Clinical Psychologist 0648284307 Reassigns benefits to 1 organization
Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

332 S Michigan Ave
Suite 900
Chicago, IL 60604-4393
Phone (312) 917-1240

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071-02554ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor on Demand Professionals P C CurrentSince Nov 1, 2023 Accepting new patients
Ctyr Publishing, Inc. Clinical PastSince Jul 7, 1997 Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

801 Adlai Stevenson Dr
Springfield, IL 62703
Phone 4153603833 ext. 03833

Interoperability endpoints

  • Direct secure messaging: john.mayer.1@30520.direct.athenahealth.com

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790816841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E WASHINGTON ST",
            "address_2": "38TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606022103",
            "telephone_number": "312-917-1240",
            "fax_number": "312-917-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E WASHINGTON ST",
            "address_2": "38TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606022103",
            "telephone_number": "312-917-1240",
            "fax_number": "312-917-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-02554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.