Shannon Kathleen Riley, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007393 Issued in IL

Practice address

800 E Northwest Hwy Ste 960
Palatine, IL 60074-6512

Phone

(847) 204-2966

NPI assigned

Jan 30, 2008

Last updated

Mar 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: primepsych@ymail.com

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1932386117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 MEADOWLARK",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "60108",
            "telephone_number": "847-204-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E NORTHWEST HWY STE 960",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600746512",
            "telephone_number": "847-204-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "SHANNON",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "primepsych@ymail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "120 W Eastman St Ste 200",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600045949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard J Powers, DPM
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• Jean R Richardson, BCBA
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• Elizabeth Rische
• Rise Strong Counseling PLLC
• Robert E. Bradley DDS & Robert J. Angerame DDS LTD
• Karen Lynett Roberts, NP-C
• Melisa Roberts, MSW, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.