Kimberly J Chivers, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007991 Issued in IL

Practice address

5412 N Clark St Ste 204
Chicago, IL 60640-1272

Phone

(708) 655-3835

NPI assigned

Nov 5, 2013

Last updated

Nov 5, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 30, 2024 through Jan 30, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Andersonville Counseling Center, LLC

  • Psychologist
  • Chicago, IL
  • NPI 1568867398
  NPD (past)

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1821427204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 N CLARK ST # 319",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402290",
            "telephone_number": "708-655-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5412 N CLARK ST STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401272",
            "telephone_number": "708-655-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIVERS",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008812",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ligia Chiu, PHARMD
• Lucinda Tzu-Ching Chiu
• Ming Lun Chiu, MD
• Stephen C Chiu, D.O.
• Stephen Francis Chiu
• Anton Chivu
• Sitaram Venkata Chivukula
• Chiworld Media Service Inc
• Mary Grace Chizewski
• Masha Chizhik

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.