DR. ANDREW VINCENT SHACK (NPI# 1659327229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659327229 |
| Entity Type | Individual |
| Full Name | DR. ANDREW VINCENT SHACK |
| Credential | PH.D. |
| Practice Address |
1103 Westgate St Suite 200 Oak Park IL 60301-1088 |
| Practice Telephone | 7083868112 |
| Practice Fax Number | 7083834298 |
| Mailing Telephone | 7083868112 |
| Mailing Fax Number | 7083834298 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2014-02-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071-006231 | IL | Behavioral Health & Social Service Providers |
| Street Address |
1103 WESTGATE ST SUITE 200 |
| City | OAK PARK |
| State | IL |
| Zip Code | 60301-1088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548556491 | Maria Cecilia Dahn, M.d. | Clinic/Center | 1103 Westgate St, 203, Oak Park, IL 60301-1088 | 2011-06-20 |
| 1942491519 | Maria Cecilia Dahn | Psychiatry & Neurology | 1103 Westgate St, #203, Oak Park, IL 60301-1088 | 2007-08-07 |
| 1205950300 | Florence R Braum | Social Worker | 1103 Westgate St, Suite 200, Oak Park, IL 60301-1088 | 2007-03-16 |
| 1134250152 | Robert Edward O'connor | Psychologist | 1103 Westgate St, Suite 200, Oak Park, IL 60301-1088 | 2007-03-08 |
| 1447316443 | Maureen Sauvain Oconnor | Social Worker | 1103 Westgate St, Oak Park, IL 60301-1088 | 2006-12-28 |
| 1801821392 | Helen Z. Fleisher | Social Worker | 1103 Westgate St, Suite 200, Oak Park, IL 60301-1088 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457982332 | Heather Lea Corwin | Counselor | Blackbird Behavioral Health, 715 Lake Street, 4th Floor, Oak Park, IL 60301 | 2020-01-30 |
| 1194244400 | Kristin Burns Mind and Body | Clinic/Center | 715 Lake St Ste 703, Oak Park, IL 60301 | 2017-09-18 |
| 1538686357 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1129 Lake St., Oak Park, IL 60301 | 2017-08-23 |
| 1851835888 | Wanda Secthecia Presley | Nurse's Aide | 1140 South Lake Street, Oak Park, IL 60301 | 2016-12-09 |
| 1477914323 | Naomi Elise Heinz | Occupational Therapist | 820 North Boulevard, Kids Unlimited Therapy Services, LLC, Oak Park, IL 60301 | 2016-03-18 |
| 1316339518 | Christina Shrader | Counselor | 137 N Oak Park Ave Ste 123, Oak Park, IL 60301 | 2015-02-24 |
| 1356755334 | Grief Recovery Group, Inc | Social Worker | 1010 Lake Street, Suite 620, Oak Park, IL 60301 | 2014-06-17 |
| 1700137239 | Christine Marie Hare | Nurse Practitioner | 1100 Lake St Ste 120, Oak Park, IL 60301 | 2012-09-24 |
| 1427334622 | Ina N. Owens | Social Worker | 137 N. Oak Park Ave, Oak Park, IL 60301 | 2011-11-01 |
| 1265720130 | Debora S Crowley | Occupational Therapist | 820 North Blvd., Oak Park, IL 60301 | 2011-07-13 |
| Find all providers in zip 60301 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710511514 | Kirsten T Svejda, Psyd, LLC | Psychologist | 101 N Marion St Ste 202, Oak Park, IL 60301-1023 | 2020-03-02 |
| 1497397228 | Priebe Psychological & Wellness | Psychologist | 101 N Marion St Ste 201, Oak Park, IL 60301-1023 | 2019-10-14 |
| 1487200861 | Lisa Lombard | Psychologist | 332 N Scoville Ave, Oak Park, IL 60302-2263 | 2019-08-12 |
| 1376015396 | Susan Longley | Psychologist | 851 Washington Blvd Apt A2, Oak Park, IL 60302-3851 | 2019-01-02 |
| 1942703632 | Jaclyn Marie Patricia Fleck | Psychologist | 806 North Blvd Apt 202, Oak Park, IL 60301-1383 | 2018-03-09 |
| 1992162721 | Caitlin Wurster | Psychologist | 137 N Oak Park Ave Ste 302, Oak Park, IL 60301-1339 | 2016-01-25 |
| 1548636541 | Kari Terrill | Psychologist | 610 S Maple Ave Ste 5601, Oak Park, IL 60304-1091 | 2015-08-13 |
| 1386903193 | Amanda Kim | Psychologist | 530 Washington Blvd Apt 3e, Oak Park, IL 60302-4063 | 2012-05-14 |
| 1578839585 | Olga Mikhaylovna Slavin-spenny | Psychologist | 25900 Greenfield Rd Ste 502, Oak Park, MI 48237-1890 | 2012-03-25 |
| 1457639619 | James Galezewski and Associates | Psychologist | 1045 S Ridgeland Ave, Oak Park, IL 60304-2123 | 2011-07-21 |
| Find all providers in OAK PARK | ||||
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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.