Individual provider Active NPI

Victoriya Tsaran, PSY.D.,LPC

  • Clinical Psychologist
  • Arlington Heights, IL
National Provider Identifier
1891176012
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009176 Issued in IL
Practice address
637 E Golf Rd
209
Arlington Heights, IL 60005-4967
Phone
(847) 791-1580
NPI assigned
Jun 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 178008016 IL
Clinical Psychologist 103TC0700X 071009176 IL Primary

Addresses

Primary practice location

637 E Golf Rd
209
Arlington Heights, IL 60005-4967

Mailing address

666 Mallard LN
Deerfield, IL 60015-3630
Phone (847) 791-1580

Other names 1

  • Victoriya Kogan Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160209002379 IL Practitioner - Clinical Psychologist 5597069724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Progressive Psychological Healthcare SCGroup PAC ID 8527366939, 10 clinicians

Practice addresses (Care Compare)

750 W Lake Cook Rd
Suite 190
Buffalo Grove, IL 60089-2084
Phone (847) 979-0268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071009176ILMDClinical Psychologist
178008016ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Psychological Healthcare, S.C. CurrentSince Feb 26, 2016 Accepting new patients
Marianna Tsaran MD SC PastSince Feb 26, 2016 Accepting new patients
In Home Health, LLC Past Accepting new patients

Locations

637 E Golf Rd
Ste 209
Arlington Hts, IL 60005
Phone (847) 258-5098

1100 W Lake Cook Rd
Ste 2
Buffalo Grove, IL 60089

750 W Lake Cook Rd
Ste 190
Buffalo Grove, IL 60089
Phone (847) 979-0268

1100 W Lake Cook Rd
Ste 210
Buffalo Grove, IL 60089
Phone (847) 979-0268

1100 W Lake Cook Rd
Ste 130
Buffalo Grove, IL 60089
Phone (847) 439-5359

2551 N Clark St
Ste 300
Chicago, IL 60614
Phone (847) 979-0268

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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1891176012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 MALLARD LN",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600153630",
            "telephone_number": "847-791-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 E GOLF RD",
            "address_2": "209",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054967",
            "telephone_number": "847-791-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSARAN",
        "first_name": "VICTORIYA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.,LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "178008016",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIYA",
            "last_name": "KOGAN",
            "credential": "PSY.D., LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.