Individual provider Active NPI

Kristen M Haut

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1922651645
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.009955 Issued in IL
Practice address
1750 W. Harrison, Jelke Building Ste 1425
Chicago, IL 60612-6061
Phone
(312) 563-1062
NPI assigned
Jul 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.009955 IL
Clinical Psychologist 103TC0700X 071.009955 IL Primary

Addresses

Primary practice location

1750 W. Harrison, Jelke Building Ste 1425
Chicago, IL 60612-6061

Mailing address

1615 N Winchester Ave Apt 1
Chicago, IL 60622-1364

Other practice location 1

1615 N Winchester Ave Apt 1
Chicago, IL 60622-1364
Phone (314) 761-3565

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191004000326 IL Practitioner - Clinical Psychologist 3577894633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

2150 W Harrison St
Chicago, IL 60612-3706
Phone (312) 942-5375

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.009955ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince Nov 1, 2020 Accepting new patients
Rush University Medical Group Clinical CurrentSince Nov 1, 2020 Accepting new patients

Locations

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1750 W Harrison St
Ste 1425
Chicago, IL 60612
Phone (312) 563-1062

2150 W Harrison St
Chicago, IL 60612
Phone (312) 563-1212

75 Remittance Dr
Dept 1611
Chicago, IL 60675

Interoperability endpoints

  • Direct secure messaging: khaut158712@direct.rush.rush-health.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1922651645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 N WINCHESTER AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 W. HARRISON, JELKE BUILDING STE 1425",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606126061",
            "telephone_number": "312-563-1062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1615 N Winchester Ave Apt 1",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606221364",
            "country_code": "US",
            "telephone_number": "314-761-3565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUT",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.009955",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.