Bonnie S Kallen, PSY. D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

1 Tiffany PT
Ste. #111
Bloomingdale, IL 60108-2936

Phone

(630) 980-1400

Fax

(630) 980-1441

NPI assigned

Dec 1, 2006

Sex

Female

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, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Affiliated Clinical Psychologists

  • Psychologist
  • Bloomingdale, IL
  • NPI 1720156201
  NPD (past)
• Affiliated Clinical Psychologists Limited

  • Psychologist
  • Bloomingdale, IL
  • NPI 1457547457
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992873384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE TIFFANY POINT",
            "address_2": "STE. #111",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "60108",
            "telephone_number": "630-980-1400",
            "fax_number": "630-980-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT",
            "address_2": "STE. #111",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082936",
            "telephone_number": "630-980-1400",
            "fax_number": "630-980-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLEN",
        "first_name": "BONNIE",
        "middle_name": "S",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.