DR. RAY EDWARD QUACKENBUSH (NPI# 1619970357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619970357 |
| Entity Type | Individual |
| Full Name | DR. RAY EDWARD QUACKENBUSH |
| Credential | PSY.D. |
| Practice Address |
4801 W Peterson Ave Ste 525 Chicago IL 60646-5731 |
| Practice Telephone | 7732863100 |
| Practice Fax Number | 7737777543 |
| Mailing Telephone | 7732863100 |
| Mailing Fax Number | 7737777543 |
| Enumeration Date | 2005-05-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
IL | Behavioral Health & Social Service Providers |
| Street Address |
4801 W PETERSON AVE STE 525 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60646-5731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667315 | Barry M Leavitt | Psychologist | 4801 W Peterson Ave, Ste 525, Chicago, IL 60646 | 2005-05-24 |
| 1790229441 | Valerie Deutsch | Behavioral Analyst | 4801 W Peterson Ave, Suite 512, Chicago, IL 60646-5713 | 2016-12-15 |
| 1730623729 | A Dragonfly Mind, LLC | Clinical Neuropsychologist | 4801 W Peterson Ave, Suite 301, Chicago, IL 60646-5726 | 2016-12-09 |
| 1760938260 | Catherine Bogacki | Social Worker | 4801 W Peterson Ave, Suite 308, Chicago, IL 60646-5713 | 2016-08-25 |
| 1841662434 | Paul Robert Muhr | Dentist | 4801 W Peterson Ave, Suite 407, Chicago, IL 60646-5713 | 2015-10-22 |
| 1548631245 | Amy Derusha | Behavioral Analyst | 4801 W Peterson Ave, 512, Chicago, IL 60646-5713 | 2015-10-07 |
| 1063818813 | Amalia Pepek | Nurse Practitioner | 4801 W Peterson Ave, Suite 506, Chicago, IL 60646-5713 | 2014-11-06 |
| 1689089286 | Roxanne Gayle | Behavioral Analyst | 4801 W Peterson Ave, #512, Chicago, IL 60646-5713 | 2014-06-23 |
| 1982018461 | Superior Rehab Center LLC | Physical Therapist | 4801 W Peterson Ave, 615, Chicago, IL 60646-5713 | 2014-06-12 |
| 1720415367 | Frank J Gutierrez | Counselor | 4801 W Peterson Ave, Suite 403, Chicago, IL 60646 | 2013-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801312087 | Manal Ibrahim | Dentist | 6228 N Keystone Ave, Chicago, IL 60646 | 2017-08-18 |
| 1750820742 | Kaitlin O'brien | Student in an Organized Health Care Education/Training Program | 5801 N Pulaski, Chicago, IL 60646 | 2017-02-23 |
| 1659810646 | Sofia Trani | Student in an Organized Health Care Education/Training Program | 5801 N. Pulaski Rd, Chicago, IL 60646 | 2017-02-23 |
| 1487191151 | Ronald E. Rysztogi | Naprapath | 5704 N. Austin, Chicago, IL 60646 | 2017-01-19 |
| 1417403148 | Joyful Dental Care | Clinic/Center | 6314 N. Cicero Avenue, Chicago, IL 60646 | 2016-09-01 |
| 1164889754 | Physicians At Call | Family Medicine | 5901 N. Cicero Ave, Ste 207, Chicago, IL 60646 | 2016-01-27 |
| 1245610617 | Arlett Payne | Physician Assistant | 5906 N Milwaukee, Chicago, IL 60646 | 2015-06-01 |
| 1811375843 | North River Mental Health Center | Community/Behavioral Health | 5801 North Pulaski Road, Chicago, IL 60646 | 2015-05-11 |
| 1003157298 | Family Choice Home Health | Homemaker | 5933 N Milwaukee Avenue, Chicago, IL 60646 | 2013-03-13 |
| 1235479593 | Antonina Skapars Trinkuns | Psychiatry & Neurology | 6404 N. Tahoma Ave., Chicago, IL 60646 | 2013-02-25 |
| Find all providers in zip 60646 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699166 | Jennifer Knuepfer, Psyd, Pllc | Psychologist | 4256 N Ravenswood Ave Ste 305, Chicago, IL 60613-1114 | 2020-11-03 |
| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1730792151 | Jenny Marie Wamsat | Psychologist | 1921 W Diversey Pkwy Apt 402, Chicago, IL 60614-9412 | 2020-08-25 |
| 1497365910 | Sara Sirota | Psychologist | 5443 N Broadway St # 2s, Chicago, IL 60640-1703 | 2020-08-10 |
| 1053920512 | Alyse Renae Bedell | Psychologist | 5841 S Maryland Ave Ste 300, Chicago, IL 60637-1443 | 2020-07-30 |
| 1699392688 | Hongying Chen | Psychologist | 720 W Sheridan Rd Apt 3s, Chicago, IL 60613-3252 | 2020-06-25 |
| 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.