Active NPI
Michael W Jones Jr., PSYD
- Psychologist
- Northbrook, IL
National Provider Identifier
1942066089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 4201 Lake Cook Rd Ste 103
Northbrook, IL 60062-1060 - Phone
- (630) 428-7890
- NPI assigned
- Feb 26, 2024
- Last updated
- Mar 11, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
4201 Lake Cook Rd Ste 103
Northbrook, IL 60062-1060
Mailing address
4201 Lake Cook Rd Ste 103
Northbrook, IL 60062-1060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edgewood Clinical Services, P.C. | Psychologist | Current | Accepting new patients |
Locations
4201 Lake Cook Rd
Ste 103
Northbrook, IL 60062
Phone (224) 467-2836
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710115200000",
"number": "1942066089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 LAKE COOK RD STE 103",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600621060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 LAKE COOK RD STE 103",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600621060",
"telephone_number": "630-428-7890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "MICHAEL",
"middle_name": "W",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-26",
"last_updated": "2024-03-11",
"certification_date": "2024-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.