Active NPI
Sharon Elizabeth Bube Tilley, PH.D.
- Psychologist
- Rochelle, IL
National Provider Identifier
1962534487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 501 6TH Ave
Suite #5
Rochelle, IL 61068-1567 - Phone
- (815) 562-7775
- NPI assigned
- Mar 10, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PE 10011 | CA | |
| Psychologist | 103T00000X | IL | Primary |
Addresses
Primary practice location
501 6TH Ave
Suite #5
Rochelle, IL 61068-1567
Mailing address
501 6TH Ave
Suite #5
Rochelle, IL 61068-1567
Phone (815) 562-7775
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7172000 | Other | IL | BC BS PSYCHOLOGIST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PE 10011 | CA | MD | Psychologist |
| 071.004012 | IL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962534487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 6TH AVE",
"address_2": "SUITE #5",
"city": "ROCHELLE",
"state": "IL",
"postal_code": "610681567",
"telephone_number": "815-562-7775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 6TH AVE",
"address_2": "SUITE #5",
"city": "ROCHELLE",
"state": "IL",
"postal_code": "610681567",
"telephone_number": "815-562-7775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEY",
"first_name": "SHARON",
"middle_name": "ELIZABETH BUBE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PE 10011",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS PSYCHOLOGIST",
"identifier": "7172000",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochelle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.