Centre City Associates

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

714501 Issued in IL

Legal business name

CENTRE CITY ASSOCIATES

Practice address

1000 Maple Ave
Downers Grove, IL 60515-4965

Phone

(630) 968-5950

Fax

(630) 968-1933

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Blattner, PH.D.

Title

Psychologist

Phone

(630) 968-5950

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1861517419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MAPLE AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154965",
            "telephone_number": "630-968-5950",
            "fax_number": "630-968-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAPLE AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154965",
            "telephone_number": "630-968-5950",
            "fax_number": "630-968-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRE CITY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "BLATTNER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "630-968-5950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "714501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.