LIFESPAN NEURODEVELOPMENTAL CONSULTANTS (NPI# 1003221755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003221755 |
| Entity Type | Organization |
| Organization Name | LIFESPAN NEURODEVELOPMENTAL CONSULTANTS |
| Practice Address |
33 N Dearborn St Suite #1600 Chicago IL 60602-3102 |
| Practice Telephone | 8474210122 |
| Practice Fax Number | 3127816706 |
| Mailing Telephone | 8474210122 |
| Mailing Fax Number | 3127816706 |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2014-06-20 |
| Authorized Official Name | DR. MATTHEW PAUL RICHMOND (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 8474210122 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
071008839 | IL | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
071008839 | IL | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
071008839 | IL | Behavioral Health & Social Service Providers |
| N | 103TF0000X |
Psychologist Specialization: Family |
071008839 | IL | Behavioral Health & Social Service Providers |
| N | 103TH0004X |
Psychologist Specialization: Health |
071008839 | IL | Behavioral Health & Social Service Providers |
| N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
071008839 | IL | Behavioral Health & Social Service Providers |
| N | 103TR0400X |
Psychologist Specialization: Rehabilitation |
071008839 | IL | Behavioral Health & Social Service Providers |
| Y | 103G00000X | Clinical Neuropsychologist | 071008839 | IL | Behavioral Health & Social Service Providers |
| Street Address |
33 N DEARBORN ST SUITE #1600 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60602-3102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770630717 | Paul Vivian Harris | Psychologist | 33 N Dearborn St, Suite 901, Chicago, IL 60602-3102 | 2007-01-04 |
| 1336492115 | Crystal R. Patel, D.d.s, PC | Dentist | 33 N Dearborn St, Suite 2400, Chicago, IL 60602-3102 | 2012-10-18 |
| 1598053258 | Nardene Karaman | Dentist | 33 N Dearborn St, Ste 2400, Chicago, IL 60602-3102 | 2011-07-15 |
| 1982829545 | Chirochicago Chiropractic & Sports Injury Center, Ltd. | Chiropractor | 33 N Dearborn St, Suite 2323, Chicago, IL 60602-3102 | 2007-04-17 |
| 1598886772 | Amber J Bayee | Social Worker | 33 N Dearborn St, Suite 901, Chicago, IL 60602-3102 | 2007-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710539705 | Biyang Wang | Social Worker | 9 W Washington St, Chicago, IL 60602 | 2019-07-10 |
| 1538724349 | Megan Asta Sarasek | Social Worker | 134 N Lasalle Street, Suite 400, Chicago, IL 60602 | 2019-05-07 |
| 1659850691 | Sara Chen | Dentist | 105 West Madison, 3rd Floor, Chicago, IL 60602 | 2018-08-10 |
| 1942795059 | Pratiti Rajeshkumar Gandhi | Dentist | 33 N Dearborn St Ste 2400, Chicago, IL 60602 | 2018-06-30 |
| 1154833994 | Ywca Metropolitan Chicago | Counselor | 1 North Lasalle Street, Suite 1150, Chicago, IL 60602 | 2017-11-02 |
| 1013434620 | Michelle Malters | Counselor | 30 N Michigan Ave Ste 1909, Chicago, IL 60602 | 2017-08-24 |
| 1740729474 | Jd Manikowski, D.d.s., LLC | Health Maintenance Organization | 30 N. Michigan Ave #1520, Chicago, IL 60602 | 2017-02-14 |
| 1568909943 | Pratiksha Agrawal | Dentist | 105 W Madison St Fl 3, Chicago, IL 60602 | 2017-01-24 |
| 1790221521 | Anastasia Scangas | Social Worker | 30 N Michigan Ave Ste 826, Chicago, IL 60602 | 2017-01-18 |
| 1194269837 | Jenna Peterson | Psychologist | 111 N Wabash Ave Ste 822, Chicago, IL 60602 | 2016-12-15 |
| Find all providers in zip 60602 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649830159 | Natalie Berger | Clinical Neuropsychologist | 1645 W Jackson Blvd Ste 203, Chicago, IL 60612-3227 | 2019-06-17 |
| 1225575871 | Israel Gross | Clinical Neuropsychologist | 1934 W. Roscoe St., #4, Chicago, IL 60657 | 2017-01-20 |
| 1144680703 | Brenda Henderson | Clinical Neuropsychologist | 7958 S Michigan Ave, Chicago, IL 60619-3509 | 2016-02-25 |
| 1386002871 | Karen Rottier | Clinical Neuropsychologist | 1539 W Oakdale Ave, Chicago, IL 60657-4010 | 2016-01-29 |
| 1952784589 | Jana Wingo | Clinical Neuropsychologist | 320 E Superior St, Chicago, IL 60611-3010 | 2015-07-01 |
| 1275947236 | Mattthew Paul Richmond | Clinical Neuropsychologist | 33 N Dearborn St Ste 1600, C/o Dr. Matthew Richmond, Chicago, IL 60602-3102 | 2014-06-18 |
| 1437578044 | Jason Ryan Soble | Clinical Neuropsychologist | 912 S Wood St # Mc913, Chicago, IL 60612-4300 | 2014-04-10 |
| 1245671841 | David A Meyerson | Clinical Neuropsychologist | 2500 W Bradley Pl, Suite 100, Chicago, IL 60618-4702 | 2013-07-11 |
| 1700136850 | Melissa Shoemaker | Clinical Neuropsychologist | 2835 N Sheffield Ave Ste 202, Chicago, IL 60657-5083 | 2012-09-17 |
| 1518214451 | Christopher Conley Stewart | Clinical Neuropsychologist | 1645 W Jackson Blvd Ste 400, Chicago, IL 60612-3244 | 2012-08-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.