Joel Daniel Wyatt, MS

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071010570 Issued in IL

Practice address

1645 W Jackson Blvd Ste 602
Chicago, IL 60612-2847

Phone

(312) 942-8387

NPI assigned

May 24, 2018

Last updated

Sep 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Clinical

  Medicare reassignment Care Compare group NPD
• Rush University Medical Center

  dba Rush Oak Brook

  • Internal Medicine Physician
  • Oak Brook, IL
  • NPI 1801375696
  NPD
• Ohio University Psychology and Social Work Clinic

  • Clinical Psychologist
  • Athens, OH
  • NPI 1972723971
  NPD (past)

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1861983975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 602",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122847",
            "telephone_number": "312-942-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 602",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122847",
            "telephone_number": "312-942-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 OHIO UNIVERSITY DEPT OF PSYCHOLOGY",
            "address_2": "PORTER HALL ROOM 002",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "45701",
            "country_code": "US",
            "telephone_number": "740-593-0902",
            "fax_number": "740-593-4790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "JOEL",
        "middle_name": "DANIEL",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010570",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Wyant, LPC
• Amanda Wyatt, MPT
• Dovilan Wyatt, M.D
• Helen Wyatt
• James Kelley Wyatt, PH.D.
• Laura Wyatt
• Matthew Monroe Wyatt, M.D.
• Rose Marie Wyatt, LCSW
• Hannah Wychocki, PA-C
• Suzanne Wychocki, LCSW

• 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 2, 2021; 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.