Jon-Paul Champine, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006739 Issued in IL

Practice address

503 Park Dr Ste 6
Kenilworth, IL 60043-1094

Phone

(847) 571-4985

NPI assigned

Sep 7, 2005

Sex

Male

Sole proprietor

Yes

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Jon-Paul Champine, Psy.D., P.C.

  • Clinical Psychologist
  • Evanston, IL
  • NPI 1629377882
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1982698833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 PARK DR STE 6",
            "city": "KENILWORTH",
            "state": "IL",
            "postal_code": "600431094",
            "telephone_number": "847-571-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 PARK DR STE 6",
            "city": "KENILWORTH",
            "state": "IL",
            "postal_code": "600431094",
            "telephone_number": "847-571-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPINE",
        "first_name": "JON-PAUL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Art Carpenter DDS LTD
• Tiffiny Brinkley, MPT
• Beth Britton, M.A.
• Conrad James Burghardt
• Arthur B. Carpenter, DDS LTD
• Miriam Levitan Dani, DDS
• David S. Duda DDS PC
• Lauren Detjen, FNP-BC
• Paul Finly Detjen, MD
• Jennifer L. Dressler, MA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.