Active NPI
Stephanie M Green, PSY.D.
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1992379283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 390200000X
- Practice address
- 625 N Michigan Ave Ste 2550
Chicago, IL 60611-3182 - Phone
- (312) 477-2120
- NPI assigned
- May 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 390200000X | IL | Primary |
Addresses
Primary practice location
625 N Michigan Ave Ste 2550
Chicago, IL 60611-3182
Mailing address
625 N Michigan Ave Ste 2550
Chicago, IL 60611-3182
Phone (312) 477-2120
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
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Psychiatric Partners, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Chicago, IL
- NPI 1982873766
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1992379283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 N MICHIGAN AVE STE 2550",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606113182",
"telephone_number": "312-477-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 N MICHIGAN AVE STE 2550",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606113182",
"telephone_number": "312-477-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "STEPHANIE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-19",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "390200000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.