Chicago Practice in Psychology

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006431 Issued in IL

Legal business name

CHICAGO PRACTICE IN PSYCHOLOGY

Practice address

53 West Jackson
Suite 602
Chicago, IL 60604-3448

Phone

(773) 718-0364

Fax

(312) 212-1705

NPI assigned

Sep 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Blake Suth, PH.D.NPI 1679663991

Title

President

Phone

(773) 718-0364

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew Blake Suth, PH.D.

  • Clinical Psychologist
  • Yorkville, IL
  • NPI 1679663991
  NPD (past) Authorized official
• Sarita Bhakuni, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1366483703
  NPD (past)

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1861700544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 WEST JACKSON",
            "address_2": "SUITE 602",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043448",
            "telephone_number": "773-718-0364",
            "fax_number": "312-212-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 WEST JACKSON",
            "address_2": "SUITE 602",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043448",
            "telephone_number": "773-718-0364",
            "fax_number": "312-212-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO PRACTICE IN PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "SUTH",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-718-0364",
        "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": "071006431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Sep 16, 2010; 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.