Timothy W Pedigo, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071003996 Issued in IL

Practice address

3624 W 216TH St
Matteson, IL 60443-2713

Phone

(708) 481-4080

Fax

(708) 481-7725

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Center Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Matteson, IL
  • NPI 1902982127
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861586760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 W 216TH ST",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432713",
            "telephone_number": "708-481-4080",
            "fax_number": "708-481-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 W 216TH ST",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432713",
            "telephone_number": "708-481-4080",
            "fax_number": "708-481-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDIGO",
        "first_name": "TIMOTHY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071003996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01636410",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desiree Patillo
• Patrice Patton-Campbell, LCPC, NCC
• PC Xpress Inc
• Peaceful Mind Therapeutics PLLC
• Karen L. Pedigo, PHD
• Tiffany N. Perdue, FNP-BC
• Keri Perillo, LCPC, CADC
• Personal Care Pharmacy
• Quanesha Phillips
• Sheila M. Pijus

• Psychologist in Matteson, IL
• Providers in Matteson, IL by specialty
• Psychologist in Illinois

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.