Active NPI
Yvonne Shade Zeldow, PHD
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1881660611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071002598
- Practice address
- 4501 N Winchester Ave
2ND FL
Chicago, IL 60640 - Phone
- (773) 250-0500
- Fax
- (773) 250-0497
- NPI assigned
- Feb 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071002598 | IL | Primary |
Addresses
Primary practice location
4501 N Winchester Ave
2ND FL
Chicago, IL 60640
Mailing address
4501 N Winchester Ave
3Rd FL
Chicago, IL 60640
Phone (773) 250-0500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 071002598 | Medicaid | IL |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071002598 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chicago Institute of Neurosurgery & Neuroresearch | Past | Accepting new patients |
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 and National Provider Directory roles.
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- NPI 1326099391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1881660611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4501 N WINCHESTER AVE",
"address_2": "3RD FL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60640",
"telephone_number": "773-250-0500",
"fax_number": "773-250-0497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4501 N WINCHESTER AVE",
"address_2": "2ND FL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60640",
"telephone_number": "773-250-0500",
"fax_number": "773-250-0497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHADE ZELDOW",
"first_name": "YVONNE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-23",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071002598",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "071002598",
"state": "IL"
}
],
"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 Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.