Individual provider Active NPI

Christina S Bailey, PSYD

  • Clinical Child & Adolescent Psychologist
  • Libertyville, IL
National Provider Identifier
1992022172
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
071007893 Issued in IL
Practice address
31480 N US Highway 45
Libertyville, IL 60048-9444
Phone
(847) 680-2715
Fax
(847) 680-3832
NPI assigned
Apr 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 071007893 IL Primary

Addresses

Primary practice location

31480 N US Highway 45
Libertyville, IL 60048-9444

Mailing address

31480 N US Highway 45
Libertyville, IL 60048-9444
Phone (847) 680-2715

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
071007893ILMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272931200000",
    "number": "1992022172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31480 N US HIGHWAY 45",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600489444",
            "telephone_number": "847-680-2715",
            "fax_number": "847-680-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31480 N US HIGHWAY 45",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600489444",
            "telephone_number": "847-680-2715",
            "fax_number": "847-680-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "CHRISTINA",
        "middle_name": "S",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-27",
        "last_updated": "2010-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071007893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; 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.