Organization Active NPI

West Suburban Psychological Services, LTD.

  • Clinical Psychologist
  • Naperville, IL
National Provider Identifier
1912031659
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
WEST SUBURBAN PSYCHOLOGICAL SERVICES, LTD.
Practice address
1809 North Mill Street
Suite G
Naperville, IL 60563
Phone
(630) 585-0039
Fax
(630) 585-1491
NPI assigned
Mar 15, 2007
Last updated
Jan 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Samuel Rest, PH.D.
Title
Owner
Phone
(630) 585-0039

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

1809 North Mill Street
Suite G
Naperville, IL 60563

Mailing address

1809 North Mill Street
Suite G
Naperville, IL 60563
Phone (630) 585-0039

Other identifiers 1

IdentifierTypeStateIssuer
04522270OtherILBCBS

National Provider Directory

National Provider Directory

Locations

1809 N Mill St
Ste G
Naperville, IL 60563
Phone (331) 575-5035

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1912031659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 NORTH MILL STREET",
            "address_2": "SUITE G",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60563",
            "telephone_number": "630-585-0039",
            "fax_number": "630-585-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 NORTH MILL STREET",
            "address_2": "SUITE G",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60563",
            "telephone_number": "630-585-0039",
            "fax_number": "630-585-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SUBURBAN PSYCHOLOGICAL SERVICES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "REST",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-585-0039",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04522270",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.