Active NPI
Laura Benedict Pettineo, PHD
- Clinical Psychologist
- Glenview, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071009478
- Practice address
- 2180 Pfingsten Rd Ste 2000
Glenview, IL 60026-1339 - Phone
- (847) 425-6400
- NPI assigned
- Jun 2, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071009478 | IL | Primary |
Addresses
Primary practice location
2180 Pfingsten Rd Ste 2000
Glenview, IL 60026-1339
Mailing address
2180 Pfingsten Rd Ste 2000
Glenview, IL 60026-1339
Phone (847) 425-6400
Other names 1
- Laura Jeanne Benedict
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lpettineo264523@direct.northshore.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2100 Pfingsten Rd
Glenview, IL 60026-1301
2650 Ridge Ave
Evanston, IL 60201-1700
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.9 of 100
- Quality
- 75.91
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 74.6
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Endeavor Health Medical Group | Current | Accepting new patients |
Locations
9532 Eagle Way
Chicago, IL 60678
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175
2180 Pfingsten Rd
Ste 2000
Glenview, IL 60026
Interoperability endpoints
- lpettineo264523@direct.northshore.org
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
-
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Evanston, IL
- NPI 1184670549
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617753600000",
"number": "1912319484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2180 PFINGSTEN RD STE 2000",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600261339",
"telephone_number": "847-425-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 PFINGSTEN RD STE 2000",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600261339",
"telephone_number": "847-425-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTINEO",
"first_name": "LAURA",
"middle_name": "BENEDICT",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-02",
"last_updated": "2021-04-07",
"certification_date": "2021-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071009478",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lpettineo264523@direct.northshore.org",
"affiliation": "N",
"address_1": "2180 Pfingsten Rd Ste 2000",
"city": "Glenview",
"state": "IL",
"country_code": "US",
"postal_code": "600261339",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LAURA",
"last_name": "BENEDICT",
"middle_name": "JEANNE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Glenview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.