Active NPI
Douglas Demerchant, PSY.D.
- Clinical Psychologist
- Wheaton, IL
National Provider Identifier
1831564228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071003669
- Practice address
- 620 W Roosevelt Rd Ste D1
Wheaton, IL 60187-2306 - Phone
- (630) 462-1999
- Fax
- (630) 462-0069
- NPI assigned
- Dec 10, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071003669 | IL | Primary |
Addresses
Primary practice location
620 W Roosevelt Rd Ste D1
Wheaton, IL 60187-2306
Mailing address
620 W Roosevelt Rd Ste D1
Wheaton, IL 60187-2306
Phone (630) 462-1999
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
| License | State | Type | Specialty |
|---|---|---|---|
| 071003669 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449705600000",
"number": "1831564228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 W ROOSEVELT RD STE D1",
"city": "WHEATON",
"state": "IL",
"postal_code": "601872306",
"telephone_number": "630-462-1999",
"fax_number": "630-462-0069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 W ROOSEVELT RD STE D1",
"city": "WHEATON",
"state": "IL",
"postal_code": "601872306",
"telephone_number": "630-462-1999",
"fax_number": "630-462-0069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMERCHANT",
"first_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-10",
"last_updated": "2015-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071003669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.