Individual provider Active NPI

Cheryl L Mejta, PHD

  • Psychologist
  • Chicago, IL
National Provider Identifier
1861581365
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
71002946 Issued in IL
Practice address
2835 N Sheffield Ave
Suite 500
Chicago, IL 60657-5081
Phone
(773) 296-2400
Fax
(773) 296-1097
NPI assigned
Oct 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 71002946 IL Primary

Addresses

Primary practice location

2835 N Sheffield Ave
Suite 500
Chicago, IL 60657-5081

Mailing address

2835 N Sheffield Ave
Suite 500
Chicago, IL 60657-5081
Phone (773) 296-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120709000303 IL Practitioner - Clinical Psychologist 9638334139 Reassigns benefits to 1 organization
Practice locations: Oak Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baal Perazim Wellness IncGroup PAC ID 7618218587, 20 clinicians

Practice addresses (Care Compare)

3416 S Halsted St
Chicago, IL 60608-6708
Phone (773) 296-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
71002946ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Baal Perazim Wellness, Inc CurrentSince Oct 10, 2023 Accepting new patients

Locations

2835 N Sheffield Ave
Ste 500
Chicago, IL 60657
Phone (773) 525-6955

3416 S Halsted St
Chicago, IL 60608
Phone (773) 451-9444

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861581365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 N SHEFFIELD AVE",
            "address_2": "SUITE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575081",
            "telephone_number": "773-296-2400",
            "fax_number": "773-296-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 N SHEFFIELD AVE",
            "address_2": "SUITE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575081",
            "telephone_number": "773-296-2400",
            "fax_number": "773-296-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJTA",
        "first_name": "CHERYL",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "71002946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.