Constance Fullilove, PH.D., LTD.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CONSTANCE FULLILOVE, PH.D., LTD.

Practice address

205 W Randolph St
Suite 830
Chicago, IL 60606-1867

Phone

(312) 560-1808

NPI assigned

Jan 11, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Constance Anita Fullilove, PH.D.NPI 1235209529

Title

Clinical Psychologist

Phone

(312) 560-1808

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Constance Anita Fullilove, PH.D.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1235209529
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851441984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W RANDOLPH ST",
            "address_2": "SUITE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061867",
            "telephone_number": "312-560-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W RANDOLPH ST",
            "address_2": "SUITE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061867",
            "telephone_number": "312-560-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTANCE FULLILOVE, PH.D., LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FULLILOVE",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "ANITA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "312-560-1808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisol Consignado, PHARMD
• Consilia Behavioral Health, PLLC
• Dustin Corey Consol
• Constance a Fullilove PHD LTD
• Constance Dugan, P.C.
• Constance L. Bauer, LLC
• Constant Care Health, LLC
• Jodie Constant
• Ophelie Constant, MD
• Corina Constantinescu, FNP-C

• 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.