Individual provider Active NPI

Joanne Stankiewicz, PSY.D.

  • Clinical Psychologist
  • Palos Heights, IL
National Provider Identifier
1821362039
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008305 Issued in IL
Practice address
11800 S 75TH Ave
3Rd Floor
Palos Heights, IL 60463-1033
Phone
(708) 448-3300
Fax
(708) 448-6972
NPI assigned
Mar 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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 071008305 IL Primary

Addresses

Primary practice location

11800 S 75TH Ave
3Rd Floor
Palos Heights, IL 60463-1033

Mailing address

13500 Circle Dr Ste 201
Orland Park, IL 60462-1343
Phone (630) 464-3266

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
I20171017001019 IL Practitioner - Clinical Psychologist 9638445802 Practice locations: Orland Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14475 John Humphrey Dr
Suite 120
Orland Park, IL 60462-6217
Phone (630) 464-3266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071008305ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Miracare Neuro Behavioral Health, PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1821362039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 CIRCLE DR STE 201",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621343",
            "telephone_number": "630-464-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 S 75TH AVE",
            "address_2": "3RD FLOOR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631033",
            "telephone_number": "708-448-3300",
            "fax_number": "708-448-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANKIEWICZ",
        "first_name": "JOANNE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.