Organization Active NPI

Ruth M Rattenbury Psy D PC

  • Clinical Psychologist
  • Evanston, IL
National Provider Identifier
1790868586
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
RUTH M RATTENBURY PSY D PC
Practice address
600 Davis St
Suite 3E
Evanston, IL 60201-4488
Phone
(847) 644-3284
Fax
(847) 328-4838
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ruth M Rattenbury, PSY.D.NPI 1609910264
Title
President Clinical Psychologist
Phone
(847) 644-3284

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X IL Primary

Addresses

Primary practice location

600 Davis St
Suite 3E
Evanston, IL 60201-4488

Mailing address

600 Davis St
Suite 3E
Evanston, IL 60201-4488
Phone (847) 644-3284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070525000137 IL Part B Supplier - Clinic/Group Practice 9830296854 Receives reassigned benefits from 1 practitioner
Practice locations: Evanston, IL

National Provider Directory

National Provider Directory

Locations

9933 S Western Ave
Ste 203
Chicago, IL 60643
Phone (312) 730-3966

600 Davis St
Ste 3E
Evanston, IL 60201
Phone (847) 424-1241

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790868586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 DAVIS ST",
            "address_2": "SUITE 3E",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014488",
            "telephone_number": "847-644-3284",
            "fax_number": "847-328-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DAVIS ST",
            "address_2": "SUITE 3E",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014488",
            "telephone_number": "847-644-3284",
            "fax_number": "847-328-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTH M RATTENBURY PSY D PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RATTENBURY",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "847-644-3284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.