Chicago Psych Therapy Group, Inc.
NPI 1184165383ActiveOrganization· Psychologist, Clinical· Evanston, IL
Psychologist, Clinical in Evanston, Illinois, registered in NPPES in March 2017. The authorized official on file is Terry Dornak, PSYD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1184165383 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 20, 2017 |
| Last updated in NPPES | Jan 27, 2026 |
| Certified by provider | Jan 27, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 071009088 | IL |
| Counselor, Mental Health | 101YM0800X | — | — |
| Psychologist, Clinical | 103TC0700X | — | — |
| Social Worker, Clinical | 1041C0700X | — | — |
| Massage Therapist | 225700000X | — | — |
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 Part B Supplier - Clinic/Group Practice (IL) |
|---|
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