Individual provider Active NPI

Robert L. Davenport, PH.D.

  • Clinical Psychologist
  • Northbrook, IL
National Provider Identifier
1902855356
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
71-2052 Issued in IL
Practice address
1535 Lake Cook Rd
Suite # 111
Northbrook, IL 60062-1450
Phone
(847) 498-4744
Fax
(847) 498-4811
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 71-2052 IL Primary

Addresses

Primary practice location

1535 Lake Cook Rd
Suite # 111
Northbrook, IL 60062-1450

Mailing address

1535 Lake Cook Rd
Suite # 111
Northbrook, IL 60062-1447
Phone (847) 498-4744

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
71-2052ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheldon Cotler Et Al PTR North Shore Consultation Center Past Accepting new patients

Organizations & group practices 1

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902855356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 LAKE COOK RD",
            "address_2": "SUITE # 111",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621447",
            "telephone_number": "847-498-4744",
            "fax_number": "847-498-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 LAKE COOK RD",
            "address_2": "SUITE # 111",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621450",
            "telephone_number": "847-498-4744",
            "fax_number": "847-498-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "71-2052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.