Individual provider Active NPI

John P. Neafsey, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1801106729
Registry record updated Jul 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071005033 Issued in IL
Practice address
6355 N Broadway St Ste 24
Chicago, IL 60660-1477
Phone
(773) 338-4334
NPI assigned
Oct 13, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2016

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 071005033 IL Primary

Addresses

Primary practice location

6355 N Broadway St Ste 24
Chicago, IL 60660-1477

Mailing address

6355 N Broadway St Ste 24
Chicago, IL 60660-1477
Phone (773) 338-4334

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
I20240502000541 IL Practitioner - Clinical Psychologist 2466895438 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6238 N Clark St
Chicago, IL 60660-1202
Phone (773) 338-4334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071005033ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468627200000",
    "number": "1801106729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 N BROADWAY ST STE 24",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601477",
            "telephone_number": "773-338-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 N BROADWAY ST STE 24",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601477",
            "telephone_number": "773-338-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAFSEY",
        "first_name": "JOHN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-13",
        "last_updated": "2016-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.