Summerville Neuropsychology Center PC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SUMMERVILLE NEUROPSYCHOLOGY CENTER PC

Practice address

2835 N Sheffield Ave Ste 214
Chicago, IL 60657-5083

Phone

(630) 424-8900

NPI assigned

Dec 1, 2021

Organization subpart

No

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

Authorized official

Name

Randall Summerville, PSYD

Title

Owner

Phone

(630) 424-8900

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristin Elizabeth Machuta

  • Clinical Social Worker
  • Elmhurst, IL
  • NPI 1205598943
  NPD
• Daniel Polonsky, PSY.D.

  • Clinical Psychologist
  • Northbrook, IL
  • NPI 1174335111
  NPD (past)

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1922766526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 E BUTTERFIELD RD STE 102",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484880",
            "telephone_number": "630-424-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 N SHEFFIELD AVE STE 214",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575083",
            "telephone_number": "630-424-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE NEUROPSYCHOLOGY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "SUMMERVILLE",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-424-8900",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Summers
• Kendrick Dwayne Summers, PT
• Khadijah Summers
• Kori Summers, M.D.
• Sondra L Summers, MD
• Summit Counseling Group Professional Corporation
• Summit Healthcare LLC
• Summit Psychotherapy
• Summit Wellness and Nutrition PLLC
• Ronald Wayne Sumpter, M.A.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.