DR. JERRY MARK OTOOLE (NPI# 1790393650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790393650 |
| Entity Type | Individual |
| Full Name | DR. JERRY MARK OTOOLE |
| Credential | PSYD |
| Practice Address |
5700 Caton Farm Rd Plainfield IL 60586-9905 |
| Mailing Address |
12816 Timber Wood Cir Plainfield IL 60585-2974 |
| Practice Telephone | 8154678181 |
| Mailing Telephone | 2404495170 |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-07-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 071006413 | IL | Behavioral Health & Social Service Providers |
| Street Address |
5700 CATON FARM RD |
| City | PLAINFIELD |
| State | IL |
| Zip Code | 60586-9905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336658434 | Brigitte L Oetter | Social Worker | 6106 Pheasant Ridge Dr, Plainfield, IL 60586 | 2017-09-21 |
| 1851730717 | Michelle Sanchez Doersam | Physician Assistant | 16519 S. Route 59, Plainfield, IL 60586 | 2013-06-24 |
| 1295059665 | Joni Deanne Gruen | Physical Therapy Assistant | 2612 Discovery Dr., Plainfield, IL 60586 | 2010-03-15 |
| 1225229453 | James G Kulekowskis Jr. | Pharmacist | 16146 S Arbor Drive, Plainfield, IL 60586 | 2007-08-05 |
| 1346363355 | Beth Ann Boss | Speech-Language Pathologist | 16504 Mueller Cir., Plainfield, IL 60586 | 2007-04-06 |
| 1457457830 | Edward J Bruno | Radiology | 333 N Madison, Joliet, IL 60586 | 2006-09-15 |
| 1497850044 | Rachel Z Mika | Physical Therapist | 6619 Mountain Ridge Pass, Plainfield, IL 60586 | 2006-09-14 |
| 1427060888 | Neil R Fried | Podiatrist | 15921 Hometown Dr, Plainfield, IL 60586 | 2006-08-13 |
| 1497701924 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 2480 S Route 59, Plainfield, IL 60586 | 2006-05-26 |
| 1164473609 | Women's Center for Health L P | Obstetrics & Gynecology | 15900 S Frederick St, Plainfield, IL 60586 | 2006-05-12 |
| Find all providers in zip 60586 | ||||
| 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 |
|---|---|---|---|---|
| 1285299248 | Forrest Lambdon Walker Sr. | Psychologist | 506 South Avenue, Plainfield, NJ 07062 | 2019-05-06 |
| 1538621065 | Laura Moore | Psychologist | 24402 W Lockport St Ste 223, Plainfield, IL 60544-4267 | 2019-04-03 |
| 1457638868 | Tanya Canak Farman | Psychologist | 2680 E Main St Ste 205, Plainfield, IN 46168-2828 | 2011-11-14 |
| 1336310010 | Megan Pownall Willis | Psychologist | 909 Madison Ave, Plainfield, NJ 07060-2336 | 2008-03-20 |
| 1235320334 | Client-centered Counseling Associates, Inc. | Psychologist | 15726 S Frederick St, Plainfield, IL 60544-5535 | 2007-08-05 |
| 1427264415 | Muhlenberg Regional Medical Center | Psychologist | Park Avenue and Randolph Road, Plainfield, NJ 07061-3902 | 2007-05-15 |
| 1558587543 | Kathleen Grady Waldron | Psychologist | 117 - 119 Roosevelt Ave., Ucpc Behavioral Healthcare, Plainfield, NJ 07060 | 2007-04-18 |
| 1275699373 | Jacqueline Carrie Napper | Psychologist | 1345 Marlborough Ave, Plainfield, NJ 07060-3312 | 2006-12-31 |
| 1629178389 | Nancy Agnes Durant | Psychologist | 925 Kensington Ave, Plainfield, NJ 07060-2619 | 2006-09-23 |
| 1497859078 | Nicholas Francis O'riordan | Psychologist | 1705 Sierra Highlands Ct, Plainfield, IL 60586-5934 | 2006-09-12 |
| Find all providers in PLAINFIELD | ||||
| City | PLAINFIELD |
| Zip Code | 60586 |
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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.