Neurobehavioral Group PC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071007744 Issued in IL

Legal business name

NEUROBEHAVIORAL GROUP PC

Practice address

1755 Park St
#200
Naperville, IL 60563-4861

Phone

(630) 449-4270

Fax

(630) 820-2358

NPI assigned

Jul 25, 2012

Organization subpart

No

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

Authorized official

Name

Michelle R Myers, PSY.D.

Title

Owner

Phone

(773) 972-4248

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383264000000",
    "number": "1992051130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 PARK ST",
            "address_2": "#200",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605634861",
            "telephone_number": "630-449-4270",
            "fax_number": "630-820-2358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 PARK ST",
            "address_2": "#200",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605634861",
            "telephone_number": "630-449-4270",
            "fax_number": "630-820-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROBEHAVIORAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-25",
        "last_updated": "2013-11-01",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-972-4248",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071007744",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007744",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IL8063",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jared Christopher Nettleton, PHARMD, RPH
• Miriam Charlotte Neugebauer
• Linda Neuharth, OTR/L
• Jacqueline Rene Neumann, CPNP-PC
• JC Neumann
• Neurohorizon Professional Corporation
• Neurosurgery and Spine Surgery SC
• Michael John Neville, D.O.
• Rae Mora Nevling, MA, LPC
• New Creation Therapeutic Bodywork Inc.

• Clinical Neuropsychologist in Naperville, IL
• Providers in Naperville, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.