Naperville Pediatric Psychology & Development

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

71.007476 Issued in IL

Legal business name

NAPERVILLE PEDIATRIC PSYCHOLOGY & DEVELOPMENT

Practice address

1220 Hobson Rd
Suite 112
Naperville, IL 60540-8139

Phone

(630) 548-9237

Fax

(630) 548-9366

NPI assigned

Feb 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Manfre, PSY.D.

Title

Licensed Clinical Psychologist

Phone

(630) 548-9237

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1902138803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 HOBSON ROAD",
            "address_2": "SUITE 112",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60540",
            "telephone_number": "630-548-9237",
            "fax_number": "630-548-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 HOBSON RD",
            "address_2": "SUITE 112",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408139",
            "telephone_number": "630-548-9237",
            "fax_number": "630-548-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAPERVILLE PEDIATRIC PSYCHOLOGY & DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "MANFRE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "630-548-9237",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "71.007476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.