Active NPI
James Edward Vanderbosch Jr., PSY.D.
- Clinical Psychologist
- Mount Prospect, IL
National Provider Identifier
1972526796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-004671
- Practice address
- 800 E Northwest Hwy
Suite 106
Mount Prospect, IL 60056-3457 - Phone
- (847) 909-9858
- Fax
- (847) 299-4952
- NPI assigned
- Jul 25, 2006
- Last updated
- Nov 30, 2015
- Sex
- Male
- Sole proprietor
- No
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 | 071-004671 | IL | Primary |
Addresses
Primary practice location
800 E Northwest Hwy
Suite 106
Mount Prospect, IL 60056-3457
Mailing address
800 E Northwest Hwy
Suite 106
Mount Prospect, IL 60056-3457
Phone (847) 909-9858
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-004671 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448841600000",
"number": "1972526796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 E NORTHWEST HWY",
"address_2": "SUITE 106",
"city": "MOUNT PROSPECT",
"state": "IL",
"postal_code": "600563457",
"telephone_number": "847-909-9858",
"fax_number": "847-299-4952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E NORTHWEST HWY",
"address_2": "SUITE 106",
"city": "MOUNT PROSPECT",
"state": "IL",
"postal_code": "600563457",
"telephone_number": "847-909-9858",
"fax_number": "847-299-4952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERBOSCH",
"first_name": "JAMES",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2015-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-004671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Prospect, IL
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.