SHIRAZ P TATA (NPI# 1336298504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336298504 |
| Entity Type | Individual |
| Full Name | SHIRAZ P TATA |
| Credential | PH.D. |
| Practice Address |
6072 Brynwood Dr Ste 107 Rockford IL 61114 |
| Mailing Address |
6072 Brynwood Dr Ste 107 Rockford IL 61114-5829 |
| Practice Telephone | 8155192949 |
| Practice Fax Number | 8156374483 |
| Mailing Telephone | 8155192949 |
| Mailing Fax Number | 8156374483 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2018-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 071-004963 | IL | Behavioral Health & Social Service Providers |
| Street Address |
6072 BRYNWOOD DR STE 107 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083109524 | Shiraz Tata Phd LLC | Psychologist | 6072 Brynwood Dr Ste 107, Rockford, IL 61114 | 2018-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064560 | Caleb Ifeoluwa Oluwadamisi | Student in an Organized Health Care Education/Training Program | Mercy Health Javon Bea Hospital, 8201 East Riverside Boulevard, Rockford, IL 61114 | 2020-05-11 |
| 1811525959 | Seifeldin Eid | Student in an Organized Health Care Education/Training Program | Mercyhealthjavon Bea Hospital, 8201, East Riversideboulevard, IL 61114 | 2020-04-01 |
| 1073167664 | Swedishamerican Hospital | Internal Medicine | 3505 N Bell School Road, Rockford, IL 61114 | 2019-07-31 |
| 1154980076 | Anurag Gill | Student in an Organized Health Care Education/Training Program | 8201 East Riverside Boulevard, Mercy Health Javon Bea Hospital, Rockford, IL 61114 | 2019-06-13 |
| 1578121943 | Sona Najafi | Student in an Organized Health Care Education/Training Program | Mercyhealth Javon Bea Hospital, 8201 East Riverside Blvd, Rockford, IL 61114 | 2019-05-31 |
| 1760045744 | Julianna Jones | Counselor | 6653 Weaver Rd Ste 115, Rockford, IL 61114 | 2019-04-16 |
| 1952869943 | Angela Marie Hawkins | Nurse Practitioner | 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 | 2019-03-08 |
| 1376029231 | Meghan Beth Teske | Chiropractor | 3779 N. Alpine Rd., Rockfod, IL 61114 | 2018-07-13 |
| 1811401284 | Summit Radiology, LLC | Clinic/Center | 3849 N. Perryville Road, Rockford, IL 61114 | 2017-11-21 |
| 1548704299 | Rockford Orthopedic Associates, Ltd | Durable Medical Equipment & Medical Supplies | 5929 E Riverside Blvd, Rockford, IL 61114 | 2016-12-15 |
| Find all providers in zip 61114 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740747765 | Jessica Hoekstra LLC | Psychologist | 8275 Peachtree Ave Ne, Rockford, MI 49341-9303 | 2019-02-26 |
| 1972900140 | Heather Hess | Psychologist | 556 Highlander Dr Ne, Rockford, MI 49341-7202 | 2014-12-03 |
| 1780934166 | Directcare Physician Services, S.c. | Psychologist | 7117 Crimson Ridge Dr, Suite 3, Rockford, IL 61107-6213 | 2012-09-13 |
| 1760787998 | Rockford Psychological Services | Psychologist | 16 North Monroe, Rockford, MI 49341 | 2011-01-19 |
| 1528243086 | Thomas B. Dudgeon, Ph.d., PC | Psychologist | 6066 Strathmoor Dr, Suite 3c, Rockford, IL 61107-6633 | 2008-01-03 |
| 1386773976 | Joe H. Vaughn | Psychologist | 4875 Manhattan Dr, Rockford, IL 61108-2265 | 2007-03-02 |
| 1730258898 | Renee A Mcardle Sr. | Psychologist | 4873 Manhattan Dr, Rockford, IL 61108-2265 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275265 | Susan Benjamin Feingold Psyd and Associates LLC | Psychologist | 1038 N Crosby St, Chicago, IL 60610-2404 | 2020-11-02 |
| 1326648247 | Ashley Head | Psychologist | 1161 S Walnut Ave, Arlington Heights, IL 60005-3053 | 2020-10-29 |
| 1932709052 | Mitchell B. Hoberman, Psy.d., P.C. | Psychologist | 8952 Samoset Trl, Skokie, IL 60076-1914 | 2020-10-28 |
| 1013524818 | Lincoln Park Psychology, Inc. | Psychologist | 644 W Webster Ave # B, Chicago, IL 60614-3710 | 2020-09-25 |
| 1962016386 | Brittney Aubin | Psychologist | 2555 N Clark St Apt 201, Chicago, IL 60614-1722 | 2020-09-02 |
| 1548873771 | Michael Wierman | Psychologist | 545 Newport Ct, Island Lake, IL 60042-9137 | 2020-08-27 |
| 1295348506 | Amaoli LLC | Psychologist | 164 Division St Ste 617, Elgin, IL 60120-5533 | 2020-08-26 |
| 1770192130 | Justin Davis Goldman | Psychologist | 15 Spinning Wheel Rd Ste 406, Hinsdale, IL 60521-5400 | 2020-07-30 |
| 1790393650 | Jerry Mark Otoole | Psychologist | 5700 Caton Farm Rd, Plainfield, IL 60586-9905 | 2020-07-16 |
| 1376165910 | Ji Yun Kang | Psychologist | 610 E John St Rm 236, Champaign, IL 61820-5717 | 2020-05-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SHIRAZ P TATA.
| 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.