Individual provider Active NPI

Petya Randelova, PSY.D

  • Clinical Psychologist
  • Wheaton, IL
National Provider Identifier
1972146181
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.010143 Issued in IL
Practice address
2100 Manchester Rd Ste 301
Wheaton, IL 60187-4584
Phone
(708) 391-5404
NPI assigned
Oct 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.010143 IL Primary

Addresses

Primary practice location

2100 Manchester Rd Ste 301
Wheaton, IL 60187-4584

Mailing address

2100 Manchester Rd Ste 301
Wheaton, IL 60187-4584
Phone (708) 391-5404

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

State licenses

LicenseStateTypeSpecialty
071.010143ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Practical Resilience Psychological Services PLLC Clinical Current Accepting new patients
Cira Center for Behavioral Health PC CurrentSince Oct 27, 2019 Accepting new patients

Locations

155 N Michigan Ave
Ste 624
Chicago, IL 60601
Phone (312) 620-0695

2100 Manchester Rd
Ste 301
Wheaton, IL 60187
Phone (708) 391-5404

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1972146181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD STE 301",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874584",
            "telephone_number": "708-391-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD STE 301",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874584",
            "telephone_number": "708-391-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDELOVA",
        "first_name": "PETYA",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; 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.