Eiko Komuro Venovic, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071008008 Issued in IL

Practice address

2100 Manchester Rd
Suite #1510
Wheaton, IL 60187-4579

Phone

(630) 653-1717

NPI assigned

Nov 2, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hessed Psychological Services LLCGroup PAC ID 0840680575, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Hessed Psychological Services LLC

  • Clinical Neuropsychologist
  • St Charles, IL
  • NPI 1871149781
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1891095147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 CONWAY LN",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605038548",
            "telephone_number": "630-479-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD",
            "address_2": "SUITE #1510",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874579",
            "telephone_number": "630-653-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENOVIC",
        "first_name": "EIKO",
        "middle_name": "KOMURO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britt Velasquez
• Maira Velasquez
• Adithi Vemuri, DO
• Orlando Venecia, REGISTERED NURSE
• Sowmya Venkat, MS RD LDN
• Christine Mary Ventrella
• Janice Vercillo, RN
• Chloe Nicole Verhagen, RD
• Sherrill J Verhasselt, APRN
• Veronika Vlasov DC Inc.,

• Clinical Psychologist in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.