Individual provider Active NPI

Leslie Crea-Kammerer, PSYD

  • Psychologist
  • Chicago, IL
National Provider Identifier
1831494186
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
2835 N Sheffield Ave Ste 310
Chicago, IL 60657-5084
Phone
(773) 234-0695
NPI assigned
Jan 18, 2011
Last updated
May 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary
Clinical Psychologist 103TC0700X 071008168 IL

Addresses

Primary practice location

2835 N Sheffield Ave Ste 310
Chicago, IL 60657-5084

Mailing address

3930 N Pine Grove Ave Apt 1911
Chicago, IL 60613-5510
Phone (609) 221-4863

Other practice location 1

6918 Windsor Ave
Berwyn, IL 60402-3334
Phone (708) 745-5277

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
071008168ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psychology Services, LLC Psychologist CurrentSince Sep 1, 2021 Accepting new patients

Locations

2835 N Sheffield Ave
Ste 310
Chicago, IL 60657
Phone (773) 234-0695

2835 N Sheffield Ave
Ste 516
Chicago, IL 60657
Phone (773) 234-0695

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1831494186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 N PINE GROVE AVE APT 1911",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135510",
            "telephone_number": "609-221-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 N SHEFFIELD AVE STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575084",
            "telephone_number": "773-234-0695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6918 Windsor Ave",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604023334",
            "country_code": "US",
            "telephone_number": "708-745-5277",
            "fax_number": "708-795-4834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREA-KAMMERER",
        "first_name": "LESLIE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-18",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008168",
            "primary": false
        }
    ],
    "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 May 14, 2024; 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.