Morton Chester Mirman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071003339 Issued in IL

Practice address

910 Skokie Blvd
Suite 215
Northbrook, IL 60062-4013

Phone

(847) 209-1515

Fax

(847) 291-0576

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. M. Chet Mirman Other name

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, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Affiliates in Counseling LLCGroup PAC ID 1254478514, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Affiliates in Counseling LLC

  • Clinical Psychologist
  • Northbrook, IL
  • NPI 1003868472
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1891733853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 SKOKIE BLVD",
            "address_2": "SUITE 215",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624013",
            "telephone_number": "847-209-1515",
            "fax_number": "847-291-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SKOKIE BLVD",
            "address_2": "SUITE 215",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624013",
            "telephone_number": "847-209-1515",
            "fax_number": "847-291-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRMAN",
        "first_name": "MORTON",
        "middle_name": "CHESTER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071003339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH COVENTRY",
            "identifier": "884069",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M.",
            "last_name": "MIRMAN",
            "middle_name": "CHET",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Peta Minerof-Bartos, LPC
• Bonnie Carol Minsky, L.D.N., M.P.H.
• Steven Minsky, MS, HWC
• Richard A. Mintzer, M.D.
• Natalie Mirek, LCPC
• Mirna Misseha
• Bridget Mitchell, LSW
• Teresa Mitchell
• Young Mitrisin
• Jan Ah-Oi Kainoa Miyamoto, PT, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.