Individual provider Active NPI

Juan Carlos Hernandez, PHD

  • Psychologist
  • Cicero, IL
National Provider Identifier
1871425496
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071.022691 Issued in IL
Practice address
4747 W Cermak Rd
Cicero, IL 60804-2508
Phone
(312) 996-2000
NPI assigned
May 29, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.022691 IL Primary

Addresses

Primary practice location

4747 W Cermak Rd
Cicero, IL 60804-2508

Mailing address

2108 N Seminary Ave Apt 6
Chicago, IL 60614-4142
Phone (210) 630-9411

Other practice location 1

1221 E State St
Rockford, IL 61104-2231
Phone (815) 972-1000

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
I20260608003723 IL Practitioner - Clinical Psychologist 8224509443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1220 S Wood St
Chicago, IL 60608-1202

2108 N Seminary Ave
Apt 6
Chicago, IL 60614-4142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071.022691ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1780012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1871425496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 N SEMINARY AVE APT 6",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144142",
            "telephone_number": "210-630-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 W CERMAK RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042508",
            "telephone_number": "312-996-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 E State St",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611042231",
            "country_code": "US",
            "telephone_number": "815-972-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-29",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.022691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, IL

Sources for this page

Verify at the official NPI Registry.