Individual provider Active NPI

Vanessa L Owens

  • School Psychologist
  • Villa Park, IL
National Provider Identifier
1902325905
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
735646 Issued in IL
Practice address
255 S. Harvard Street
Villa Park, IL 60181
Phone
(630) 516-7641
NPI assigned
Sep 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 735646 IL Primary

Addresses

Primary practice location

255 S. Harvard Street
Villa Park, IL 60181

Mailing address

255 S. Harvard Street
Villa Park, IL 60181
Phone (630) 516-7641

Other practice location 1

150 W Sunset Ave
Villa Park, IL 60181-1540
Phone (630) 516-7641

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
735646ILMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902325905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S. HARVARD STREET",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "60181",
            "telephone_number": "630-516-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S. HARVARD STREET",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "60181",
            "telephone_number": "630-516-7641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 W Sunset Ave",
            "address_purpose": "LOCATION",
            "city": "Villa Park",
            "state": "IL",
            "postal_code": "601811540",
            "country_code": "US",
            "telephone_number": "630-516-7641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWENS",
        "first_name": "VANESSA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IL",
            "license": "735646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.