Dr. Gail Petrich, Attorney and Psychologist, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006029 Issued in IL

Legal business name

DR. GAIL PETRICH, ATTORNEY AND PSYCHOLOGIST, LLC

Practice address

1801 N Mill St Ste D
Naperville, IL 60563-4869

Phone

(708) 524-0171

Fax

(708) 524-4699

NPI assigned

Dec 11, 2007

Last updated

Aug 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gail Petrich, PSYDNPI 1134249154

Title

President

Phone

(708) 524-0171

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gail S Petrich, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1134249154
  Authorized official Same address or phone

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1790968873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N MILL ST STE D",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605634869",
            "telephone_number": "708-524-0171",
            "fax_number": "708-524-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N MILL ST STE D",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605634869",
            "telephone_number": "708-524-0171",
            "fax_number": "708-524-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. GAIL PETRICH, ATTORNEY AND PSYCHOLOGIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "PETRICH",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-524-0171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "0002232305",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.