Bethany L Walker, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.010558 Issued in IL

Practice address

2700 Patriot Blvd
Glenview, IL 60026-8021

Phone

(847) 231-2399

NPI assigned

Oct 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 15, 2024 through Feb 15, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Boldly You Psychotherapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glenview, IL
  • NPI 1992571988
  NPD Authorized official

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1982247813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 PATRIOT BLVD",
            "address_2": "STE 250 #500",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268021",
            "telephone_number": "847-231-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268021",
            "telephone_number": "847-231-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BETHANY",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co.
• Muazzama Waliani
• Alexis Walich, LPC
• Michael J. Waligora, MD
• Robyn Wall, PA-C
• Sheba Sharone Wallace, OTR/L
• Maria Trakas Wallach, LCSW
• Rachel C. Wallach, OTRL
• Wallman Medical Associates, S.C.

• Clinical Psychologist in Glenview, IL
• Providers in Glenview, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.