Active NPI
Sherman Martin Carter, PHD
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1861567612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Practice address
- 2800 Lake Shore Drive
Suite 3103 Jacobson and Carter
Chicago, IL 60657 - Phone
- (773) 871-1612
- Fax
- (773) 871-2202
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | IL | Primary |
Addresses
Primary practice location
2800 Lake Shore Drive
Suite 3103 Jacobson and Carter
Chicago, IL 60657
Mailing address
2800 Lake Shore Drive
Suite 3103 Jacobson and Carter
Chicago, IL 60657
Phone (773) 871-1612
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001673315 | Other | IL | BLUE CROSS BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 071000532 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861567612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 LAKE SHORE DRIVE",
"address_2": "SUITE 3103 JACOBSON AND CARTER",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60657",
"telephone_number": "773-871-1612",
"fax_number": "773-871-2202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 LAKE SHORE DRIVE",
"address_2": "SUITE 3103 JACOBSON AND CARTER",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60657",
"telephone_number": "773-871-1612",
"fax_number": "773-871-2202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "SHERMAN",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0001673315",
"state": "IL"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.