Organization Active NPI

Neuro-Psych Technologies, LTD.

  • Psychiatry Physician
  • Skokie, IL
National Provider Identifier
1932193455
Registry record updated Jan 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
042-003570 Issued in IL
Legal business name
NEURO-PSYCH TECHNOLOGIES, LTD.
Practice address
4711 Golf Rd
Suite 1200
Skokie, IL 60076-1224
Phone
(847) 446-7911
Fax
(847) 386-6239
NPI assigned
Sep 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2010

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

Authorized official

Name
Dr. David George Bawden, M.D.NPI 1881688307
Title
President
Phone
(847) 446-7911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 042-003570 IL Primary

Addresses

Primary practice location

4711 Golf Rd
Suite 1200
Skokie, IL 60076-1224

Mailing address

PO Box 8159
Northfield, IL 60093-8159
Phone (847) 446-7911

Other identifiers 2

IdentifierTypeStateIssuer
260039385OtherILRAIL ROAD RETIREMENT
2160834332OtherILBLUE CROSS NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090116000107 IL Part B Supplier - Clinic/Group Practice 3173686193 Receives reassigned benefits from 1 practitioner
Practice locations: Lisle, IL; West Chicago, IL; Skokie, IL; Northlake, IL; Northbrook, IL; Niles, IL; Itasca, IL; Indian Head Park, IL…
O20201207000034 WI Part B Supplier - Clinic/Group Practice 3173686193 Receives reassigned benefits from 1 practitioner
Practice locations: Oshkosh, WI

National Provider Directory

National Provider Directory

Locations

5000 Lincoln Ave
Lisle, IL 60532
Phone (630) 852-5100

2100 S Finley Rd
Lombard, IL 60148
Phone (630) 495-4000

3705 Deerfield Rd
#N
Riverwoods, IL 60015
Phone (847) 947-9000

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262476800000",
    "number": "1932193455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8159",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600938159",
            "telephone_number": "847-446-7911",
            "fax_number": "847-386-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 1200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "847-446-7911",
            "fax_number": "847-386-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO-PSYCH TECHNOLOGIES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2010-01-03",
        "status": "A",
        "authorized_official_last_name": "BAWDEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-446-7911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "042-003570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD RETIREMENT",
            "identifier": "260039385",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "2160834332",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.