Active NPI
Ren F Duarte, PSY.D.
- Psychologist
- Chicago, IL
National Provider Identifier
1902935208
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Mar 20, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071-006715
- Practice address
- 3200 N Lake Shore Dr
Apt. 1001
Chicago, IL 60657-1944 - Phone
- (773) 348-9960
- NPI assigned
- Mar 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071-006715 | IL | Primary |
Addresses
Primary practice location
3200 N Lake Shore Dr
Apt. 1001
Chicago, IL 60657-1944
Mailing address
3200 N Lake Shore Dr
Apt. 1001
Chicago, IL 60657-3952
Phone (773) 348-9960
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-006715 | IL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465257600000",
"number": "1902935208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 N LAKE SHORE DR",
"address_2": "APT. 1001",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606573952",
"telephone_number": "773-348-9960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 N LAKE SHORE DR",
"address_2": "APT. 1001",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606571944",
"telephone_number": "773-348-9960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUARTE",
"first_name": "REN",
"middle_name": "F",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-04",
"last_updated": "2016-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071-006715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.