NPIMap

Organization Active NPI

Crescent Psychology, PLLC

  • Psychologist
  • Northfield, IL
National Provider Identifier
1841920741
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
CRESCENT PSYCHOLOGY, PLLC
Practice address
778 W Frontage Rd Ste 111
Northfield, IL 60093-1209
Phone
(847) 220-8317
NPI assigned
Jun 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Authorized official

Name
Dr. Jessica Dubnow, PSYDNPI 1790152635
Title
Co-Owner
Phone
(847) 525-5875

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

778 W Frontage Rd Ste 111
Northfield, IL 60093-1209

Mailing address

778 W Frontage Rd Ste 111
Northfield, IL 60093-1209

National Provider Directory

National Provider Directory

Locations

778 W Frontage Rd
Ste 111
Northfield, IL 60093
Phone (847) 220-8317

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1841920741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "778 W FRONTAGE RD STE 111",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600931209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "778 W FRONTAGE RD STE 111",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600931209",
            "telephone_number": "847-220-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT PSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "DUBNOW",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "847-525-5875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.