Stephanie McConville, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009722 Issued in IL

Practice address

3145 W Pratt Blvd
Chicago, IL 60645-4125

Phone

(773) 467-3744

NPI assigned

Feb 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Our House Therapy Collective a Healing CommunityGroup PAC ID 1355708355, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Our House Therapy Collective a Healing Community

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1982277836
  Medicare reassignment Care Compare group NPD Authorized official
• Our House Therapy Collective a Healing Community

  • Adolescent and Children Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1447935580
  NPD
• Jewish Child and Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1821387119
  NPD (past)

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1912407354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 W PRATT BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606454125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 W PRATT BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606454125",
            "telephone_number": "773-467-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONVILLE",
        "first_name": "STEPHANIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362167757001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan McComb, PHARM.D.
• Heather McCombs, DPM
• James Alan McCombs, DO
• Kelli Jo McConnehey, PA-C
• Kristin McConnell, MS, CCC-SLP
• Juan Tremayne McCook
• Elizabeth Anne McCool
• Jennifer Molly McCool, LCSW
• Jessica McCool, PHYSICAL THERAPIST
• Sherree McCool

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; 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.

Verify at the official NPI Registry.