Individual provider Active NPI

Irma Porcic Khelghati, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Chicago, IL
National Provider Identifier
1891044038
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
4164 N Lincoln Ave Ste C1S
Chicago, IL 60618-3083
Phone
(312) 870-0330
Fax
(312) 312-9641
NPI assigned
Sep 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X Primary

Addresses

Primary practice location

4164 N Lincoln Ave Ste C1S
Chicago, IL 60618-3083

Mailing address

4164 N Lincoln Ave Ste C1S
Chicago, IL 60618-3083
Phone (312) 870-0330

Other names 1

  • Irma Porcic Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Journey Psychology Center, LLC CurrentSince Mar 19, 2023 Accepting new patients
Shared Vision Psychological Services Past Accepting new patients
Adam Shafer, P.C. Past Accepting new patients

Locations

4164 N Lincoln Ave
Ste C1S
Chicago, IL 60618
Phone (312) 780-0330

Organizations & group practices 3

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": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1891044038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4164 N LINCOLN AVE STE C1S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183083",
            "telephone_number": "312-870-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4164 N LINCOLN AVE STE C1S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183083",
            "telephone_number": "312-870-0330",
            "fax_number": "312-312-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHELGHATI",
        "first_name": "IRMA",
        "middle_name": "PORCIC",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRMA",
            "last_name": "PORCIC",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Mar 15, 2023; 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.