Psychology Specialists

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071008742 Issued in IL

Legal business name

PSYCHOLOGY SPECIALISTS

Practice address

350 S Northwest Hwy
Park Ridge, IL 60068-4216

Phone

(309) 706-3190

Fax

(309) 588-4115

NPI assigned

Feb 12, 2015

Last updated

Feb 12, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Kahwaji, PSYD

Title

President

Phone

(309) 706-3190

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Jennifer Rebecca Shibley, PSY.D., M.S.

  • Clinical Psychologist
  • Peoria, IL
  • NPI 1033390208
  NPD (past)

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1912398942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684216",
            "telephone_number": "309-706-3190",
            "fax_number": "309-588-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684216",
            "telephone_number": "309-706-3190",
            "fax_number": "309-588-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "KAHWAJI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-706-3190",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071008742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prohealth Homecare LLC
• Promedics Inc
• Douglas Alan Propp, MD
• Sara E Provis, LPC
• Margaret Proxmire, DPT
• Katherine Stick Puls, C.N.M./A.P.N.
• Bhagya Lakshmi Puppala, MD
• Purposecare of Illinois, LLC
• Nataliya Pyslar, M.D.
• Sanaa Qamar, M.D.

• Psychologist in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.