Individual provider Active NPI

Jean Marie Griffin, PHD

  • Clinical Psychologist
  • Skokie, IL
National Provider Identifier
1871530659
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071004509 Issued in IL
Practice address
5225 Old Orchard Rd Ste 32
Skokie, IL 60077-1027
Phone
(773) 680-2244
Fax
(847) 470-0741
NPI assigned
Jun 1, 2006
Last updated
Apr 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 071004509 IL
Clinical Psychologist 103TC0700X 071004509 IL Primary
Rehabilitation Psychologist 103TR0400X 071004509 IL

Addresses

Primary practice location

5225 Old Orchard Rd Ste 32
Skokie, IL 60077-1027

Mailing address

5008 Pratt Ave
Skokie, IL 60077-3513
Phone (773) 680-2244

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
I20060620000174 IL Practitioner - Clinical Psychologist 3476565136 Reassigns benefits to 1 organization
Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Chicago, IL 60640
Phone (773) 680-2244

5555 N Sheridan Rd
Suite 1805
Chicago, IL 60640-1638

5555 N Sheridan Road
1805 1805
Chicago, IL 60640-1638

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071004509ILMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Institute of Chicago CurrentSince Sep 1, 2002 Accepting new patients

Locations

345 E Superior St
Chicago, IL 60611
Phone (312) 238-1228

900 Skokie Blvd
Northbrook, IL 60062
Phone (847) 272-7426

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1871530659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 PRATT AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773513",
            "telephone_number": "773-680-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 OLD ORCHARD RD STE 32",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771027",
            "telephone_number": "773-680-2244",
            "fax_number": "847-470-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071004509",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071004509",
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "IL",
            "license": "071004509",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.