Fraser Vaselakos & Associates, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071004958 Issued in IL

Legal business name

FRASER VASELAKOS & ASSOCIATES, PC

Practice address

12627 W 143Rd St
Homer Glen, IL 60491-8381

Phone

(708) 645-0798

Fax

(708) 645-0841

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. M. Denise Fraser Vaselakos, PSY.D.NPI 1982872594

Title

Owner

Phone

(708) 645-0798

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• M Denise Fraser Vaselakos, PSY.D.

  • Clinical Psychologist
  • Homer Glen, IL
  • NPI 1982872594
  Medicare reassignment Authorized official
• Michelle Rose Krepps, MSW LCSW

  • Clinical Social Worker
  • Homer Glen, IL
  • NPI 1477713980
  Medicare reassignment

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1821168162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12627 W 143RD ST",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918381",
            "telephone_number": "708-645-0798",
            "fax_number": "708-645-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12627 W 143RD ST",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918381",
            "telephone_number": "708-645-0798",
            "fax_number": "708-645-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRASER VASELAKOS & ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "FRASER VASELAKOS",
        "authorized_official_first_name": "M. DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-645-0798",
        "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": "071004958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Diane Flanagan, MOT, OTR/L
• Shannon Maureen Fluder, MA, LMSW
• Carolyn Elizabeth Foley, MS, CCC-SLP
• Foot and Ankle Inc
• Franciscan Communities, Inc.
• M Denise Fraser Vaselakos, PSY.D.
• Lindsey Fron
• Functional Therapy & Rehabilitation, P.C.
• Christy Galardi
• Gabriel Goldman, PT, DPT

• Clinical Psychologist in Homer Glen, IL
• Providers in Homer Glen, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.