Phyllis B Rubin, PSY D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071005880 Issued in IL

Practice address

715 Lake St
Suite 720
Oak Park, IL 60301

Phone

(708) 848-0983

Fax

(708) 848-0465

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225065600000",
    "number": "1881768489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 LAKE ST",
            "address_2": "SUITE 720",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "60301",
            "telephone_number": "708-848-0983",
            "fax_number": "708-848-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 LAKE ST",
            "address_2": "SUITE 720",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "60301",
            "telephone_number": "708-848-0983",
            "fax_number": "708-848-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "PHYLLIS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071005880",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146001732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3781254014",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31623351",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31623353",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen B. Rothstein Pineda, MA, LCPC
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• RS Hartz MD Namptp Neuropathy Dr SC
• David P. Rubalsky, M.D.
• Mark Edward Ruehl, PH.D.
• Brenda Ruiz Aragon
• Gabriel Ruiz, LCPC, NCC
• Santi Rukvidtayasas, M.D.
• Rush Oak Park ER Physicians Group

• Psychologist in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.

Verify at the official NPI Registry.