Paula T Dicanio, PHD.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Practice address

2213 Lakeside Dr
Bannockburn, IL 60015-1265

Phone

(847) 604-9441

Fax

(847) 604-9445

NPI assigned

Apr 10, 2007

Last updated

Apr 3, 2021By 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

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

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Heart & Mind Therapy, PLLC

  • Clinical Psychologist
  • Highland Park, IL
  • NPI 1497333991
  Medicare reassignment NPD Authorized official
• Aspen Behavioral Care

  • Psychologist
  • Arlington HTS, IL
  • NPI 1093761439

  Clinical

  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617408000000",
    "number": "1952524019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 LAKESIDE DR",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151265",
            "telephone_number": "847-604-9441",
            "fax_number": "847-604-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 LAKESIDE DR",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151265",
            "telephone_number": "847-604-9441",
            "fax_number": "847-604-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICANIO",
        "first_name": "PAULA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2021-04-03",
        "certification_date": "2021-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Jeremy Davidson, MD
• Amanda L. Deboy, LPC, PMH-C
• Deerfield Healthworks S C
• Caroline Degroot, MPT
• Dentistryone of Illinois PC
• Susan A Dote, DPT
• Lisa Dvorak, LPC
• Joanne Eckenhoff, PT
• Robin P Eisenberg, LCSW
• Amy Michelle Eliacin, MSW, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.