Individual provider Active NPI

Krithika Malhotra, PHD

  • Psychologist
  • Grayslake, IL
National Provider Identifier
1902219066
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071010637 Issued in IL
Practice address
1475 E Belvidere Rd Unit 385
Grayslake, IL 60030-2026
Phone
(312) 926-0106
Fax
(312) 503-1377
NPI assigned
Jun 6, 2014
Last updated
May 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2456 KS
Psychologist 103T00000X 071010637 IL Primary

Addresses

Primary practice location

1475 E Belvidere Rd Unit 385
Grayslake, IL 60030-2026

Mailing address

1475 E Belvidere Rd Unit 385
Grayslake, IL 60030-2026
Phone (312) 926-0106

Other practice location 1

3901 Rainbow Blvd
Kansas City, KS 66160-2622
Phone (913) 588-1908

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
I20220317000532 IL Practitioner - Clinical Psychologist 0840558490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1475 E Belvidere Rd
Pavilion C Suite 385
Grayslake, IL 60030-2026
Phone (312) 694-1469

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2456KSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Mar 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 1, 2022 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

1475 E Belvidere Rd
Unit 385
Grayslake, IL 60030
Phone (312) 694-1469

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1902219066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 E BELVIDERE RD UNIT 385",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302026",
            "telephone_number": "312-926-0106",
            "fax_number": "312-503-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 E BELVIDERE RD UNIT 385",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302026",
            "telephone_number": "312-926-0106",
            "fax_number": "312-503-1377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Rainbow Blvd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661602622",
            "country_code": "US",
            "telephone_number": "913-588-1908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALHOTRA",
        "first_name": "KRITHIKA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-06",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "2456",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071010637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

Verify at the official NPI Registry.