Individual provider Active NPI

Adam Hellebrand, PSYD

  • Clinical Psychologist
  • Skokie, IL
National Provider Identifier
1891149431
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071010010 Issued in IL
Practice address
4709 Golf Rd Ste 925
Skokie, IL 60076
Phone
(312) 467-0000
Fax
(312) 467-0000
NPI assigned
Apr 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Psychologist 103TC0700X 071010010 IL Primary

Addresses

Primary practice location

4709 Golf Rd Ste 925
Skokie, IL 60076

Mailing address

4709 Golf Rd Ste 925
Skokie, IL 60076-1260
Phone (312) 860-3943

Other practice location 1

1401 W 4th St
Antioch, CA 94509-1024
Phone (312) 860-3943

Other practice location 2

405 N Wabash Ave Unit 3209
Chicago, IL 60611-5675
Phone (312) 467-0000 ext. 2

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071010010ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Hellebrand, PSYD PLLC Clinical PastSince Sep 8, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1891149431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD STE 925",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761260",
            "telephone_number": "312-860-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD STE 925",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60076",
            "telephone_number": "312-467-0000",
            "fax_number": "312-467-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "CA",
            "postal_code": "945091024",
            "country_code": "US",
            "telephone_number": "312-860-3943",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 N Wabash Ave Unit 3209",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606115675",
            "country_code": "US",
            "telephone_number": "312-467-0000 x2",
            "fax_number": "312-647-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HELLEBRAND",
        "first_name": "ADAM",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.