Individual provider Active NPI

Katherine C. Wood, PH.D.

  • Clinical Neuropsychologist
  • Rolling Meadows, IL
National Provider Identifier
1942241500
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
071005574 Issued in IL
Practice address
1600 Golf Rd Ste 1200
Rolling Meadows, IL 60008-4229
Phone
(847) 636-8704
Fax
(847) 692-2993
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-005574 IL
Clinical Neuropsychologist 103G00000X 071005574 IL Primary

Addresses

Primary practice location

1600 Golf Rd Ste 1200
Rolling Meadows, IL 60008-4229

Mailing address

806 Courtland Ave
Park Ridge, IL 60068-4834
Phone (847) 636-8704

Other practice location 1

637 E Golf Rd
Ste 201
Arlington Heights, IL 60005-4070
Phone (847) 636-8704

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071-005574ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1942241500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 COURTLAND AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684834",
            "telephone_number": "847-636-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 GOLF RD STE 1200",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600084229",
            "telephone_number": "847-636-8704",
            "fax_number": "847-692-2993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "637 E Golf Rd",
            "address_2": "Ste 201",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600054070",
            "country_code": "US",
            "telephone_number": "847-636-8704",
            "fax_number": "847-692-2993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KATHERINE",
        "middle_name": "C.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-005574",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071005574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Meadows, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.