Individual provider Active NPI

Alicia Doty, PSYD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1811415359
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.009594 Issued in IL
Practice address
820 S Damen Ave
Chicago, IL 60612-3728
Phone
(312) 569-8387
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 071.009594 IL Primary

Addresses

Primary practice location

820 S Damen Ave
Chicago, IL 60612-3728

Mailing address

2030 Il Route 26
Dixon, IL 61021-9218
Phone (815) 440-4069

Other practice location 1

9301 Madison St
Crown Point, IN 46307-7745
Phone (219) 662-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071.009594ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1811415359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 IL ROUTE 26",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219218",
            "telephone_number": "815-440-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123728",
            "telephone_number": "312-569-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9301 Madison St",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463077745",
            "country_code": "US",
            "telephone_number": "219-662-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOTY",
        "first_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009594",
            "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 Mar 17, 2018; 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.