Individual provider Active NPI

David Kohler, PSY.D

  • Group Psychotherapy Psychologist
  • Chicago, IL
National Provider Identifier
1861823064
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
071008692 Issued in IL
Practice address
2153 W Belmont Ave
1
Chicago, IL 60618-7879
Phone
(773) 573-9117
NPI assigned
Dec 12, 2013
Last updated
Dec 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 071008692 IL
Cognitive & Behavioral Psychologist 103TB0200X 071008692 IL
Clinical Psychologist 103TC0700X 071008692 IL
Clinical Child & Adolescent Psychologist 103TC2200X 071008692 IL
Family Psychologist 103TF0000X 071008692 IL
Group Psychotherapy Psychologist 103TP2701X 071008692 IL Primary

Addresses

Primary practice location

2153 W Belmont Ave
1
Chicago, IL 60618-7879

Mailing address

2153 W Belmont Ave
Unit 1
Chicago, IL 60618-7879
Phone (773) 573-9117

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
071008692ILMDClinical Child & Adolescent Psychologist

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": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1861823064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2153 W BELMONT AVE",
            "address_2": "UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606187879",
            "telephone_number": "773-573-9117",
            "fax_number": "844-649-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2153 W BELMONT AVE",
            "address_2": "1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606187879",
            "telephone_number": "773-573-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLER",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "IL",
            "license": "071008692",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IL",
            "license": "071008692",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008692",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071008692",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "IL",
            "license": "071008692",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "IL",
            "license": "071008692",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 13, 2016; 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.