Active NPI
Ellyn K. Daniels, PH.D.
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1952524183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071005777
- Practice address
- 150 N Michigan Ave
Suite 2145
Chicago, IL 60601-7553 - Phone
- (312) 944-9950
- Fax
- (312) 726-8200
- NPI assigned
- Apr 10, 2007
- Last updated
- Jun 18, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071005777 | IL | Primary |
Addresses
Primary practice location
150 N Michigan Ave
Suite 2145
Chicago, IL 60601-7553
Mailing address
150 N Michigan Ave
Suite 2145
Chicago, IL 60601-7553
Phone (312) 944-9950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01632252 | Other | IL | BCBS PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Previously, effective Sep 10, 2008 through Sep 10, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071005777 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276819200000",
"number": "1952524183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 N MICHIGAN AVE",
"address_2": "SUITE 2145",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606017553",
"telephone_number": "312-944-9950",
"fax_number": "312-726-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 N MICHIGAN AVE",
"address_2": "SUITE 2145",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606017553",
"telephone_number": "312-944-9950",
"fax_number": "312-726-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "ELLYN",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-10",
"last_updated": "2010-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071005777",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "01632252",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.