NPIMap

Organization Active NPI

Tandem Psychology LLC

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1811348485
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008865 Issued in IL
Legal business name
TANDEM PSYCHOLOGY LLC
Practice address
3354 N Paulina St
205
Chicago, IL 60657-1068
Phone
(773) 273-9719
NPI assigned
Jun 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Authorized official

Name
Dr. Tyler FortmanNPI 1740691542
Title
Owner
Phone
(614) 273-5372

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: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 071008865 IL Primary

Addresses

Primary practice location

3354 N Paulina St
205
Chicago, IL 60657-1068

Mailing address

3354 N Paulina St
205
Chicago, IL 60657-1068
Phone (773) 273-9719

National Provider Directory

National Provider Directory

Locations

3354 N Paulina St
Ste 205
Chicago, IL 60657
Phone (773) 234-2137

Practitioners & affiliated clinicians

Practitioners 11

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": "1466726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1811348485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3354 N PAULINA ST",
            "address_2": "205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571068",
            "telephone_number": "773-273-9719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 N PAULINA ST",
            "address_2": "205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571068",
            "telephone_number": "773-273-9719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANDEM PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-24",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "FORTMAN",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-273-5372",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.