Illuminate Psychological Assessments, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009040 Issued in IL

Legal business name

ILLUMINATE PSYCHOLOGICAL ASSESSMENTS, LLC

Practice address

3330 Old Glenview Rd Ste 10
Wilmette, IL 60091-2963

Phone

(312) 857-6393

NPI assigned

Jul 5, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Novak, PSY.D.

Title

Manager/Clinical Psychologist

Phone

(312) 857-6393

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Noelle Kathleen Pontarelli, PHD

  • Clinical Psychologist
  • Wilmette, IL
  • NPI 1912531237

  Clinical

  NPD (past)

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1982190633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 OLD GLENVIEW RD STE 10",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912963",
            "telephone_number": "312-857-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 OLD GLENVIEW RD STE 10",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912963",
            "telephone_number": "312-857-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATE PSYCHOLOGICAL ASSESSMENTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-05",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "MANAGER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "312-857-6393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristine Hummel, LCSW CADC
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• Judith S Hylton, M.ED, MA, LCPC
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• All providers in Wilmette, IL
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; 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.