Gustavo Medrano, PHD
NPI 1043624794ActiveIndividual· Psychologist· Evanston, IL
Psychologist (PHD) with The Board of Trustees of the University of Illinois, practicing in Evanston, Illinois. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1043624794 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Jun 19, 2014 |
| Last updated in NPPES | Jun 19, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (IL) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- The Board of Trustees of the University of IllinoisChicago, IL · 1,150 clinicians
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