Individual provider Active NPI

Sonia Lynne Rubens, PHD

  • Clinical Child & Adolescent Psychologist
  • Chicago, IL
National Provider Identifier
1841555448
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
071.010692 Issued in IL
Practice address
1321 W Nelson St
Chicago, IL 60657-4215
Phone
(312) 623-9882
Fax
(312) 623-9882
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 071.010692 IL Primary

Addresses

Primary practice location

1321 W Nelson St
Chicago, IL 60657-4215

Mailing address

1321 W Nelson St
Chicago, IL 60657-4215
Phone (312) 623-9882

Other identifiers 1

IdentifierTypeStateIssuer
1841281805MedicaidKS

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.010692ILMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Sonia Rubens LLC CurrentSince Oct 8, 2023 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": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1841555448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 W NELSON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574215",
            "telephone_number": "312-623-9882",
            "fax_number": "312-623-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 W NELSON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574215",
            "telephone_number": "312-623-9882",
            "fax_number": "312-623-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBENS",
        "first_name": "SONIA",
        "middle_name": "LYNNE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071.010692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841281805",
            "state": "KS"
        }
    ],
    "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 Oct 6, 2023; 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.