Louis Joseph Formica, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.010375 Issued in IL

Practice address

3660 N Lake Shore Dr Ste 201
Chicago, IL 60613-5302

Phone

(773) 759-5126

NPI assigned

Oct 30, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Sunstone Psychology LLC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1588323331
  NPD Authorized official

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1861092686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 N LAKE SHORE DR STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135302",
            "telephone_number": "773-759-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 N LAKE SHORE DR STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135302",
            "telephone_number": "773-759-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMICA",
        "first_name": "LOUIS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010375",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IL",
            "license": "071.010375",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hawa Bindu Forkpa
• Form and Function PLLC
• Edward Forman, DO
• Karyn Beth Forman, L.AC.
• Margaret Forman, PA-C
• John Dylan Fornagiel
• Deanne C Fornelli, PA-C
• Devon Simone Forney, MA, LCPC, CAADC, NCC
• Paula Jean Forney, COTA/L
• Madeline Forouhi

• 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 Oct 30, 2020; 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.