Individual provider Active NPI

Katherine Louise Schaefer Berg, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1932347762
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.007618 Issued in IL
Practice address
1333 N Kingsbury St
Suite 100
Chicago, IL 60642-2687
Phone
(630) 386-6287
NPI assigned
Feb 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.007618 IL Primary

Addresses

Primary practice location

1333 N Kingsbury St
Suite 100
Chicago, IL 60642-2687

Mailing address

1333 N Kingsbury St
Suite 100
Chicago, IL 60642-2687
Phone (630) 386-6287

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
I20090309000524 IL Practitioner - Clinical Psychologist 4486710902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

475 Dunham Rd
Suite 1B
St Charles, IL 60174-1498
Phone (630) 386-6287

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071.007618ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Feb 2, 2009 Accepting new patients
Katherine Schaefer Berg, PH.D., P.C. CurrentSince Jan 1, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 2, 2009 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1015
Chicago, IL 60611
Phone (312) 926-9674

475 Dunham Rd
Ste 1B
St Charles, IL 60174
Phone (630) 386-6287

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1932347762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 N KINGSBURY ST",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422687",
            "telephone_number": "630-386-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 N KINGSBURY ST",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422687",
            "telephone_number": "630-386-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "KATHERINE",
        "middle_name": "LOUISE SCHAEFER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.