Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andersonville Psychology, PC

Organization Clinical Psychologist · NPI 1962924829

Andersonville Psychology, PC is a Clinical Psychologist in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2017.

Licensed in
IL
In the registry since
2017
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5412 N Clark St Ste 220
Chicago, IL 60640-1272
Phone: (773) 985-8746
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 071.009490 (IL)

Record details

NPI number1962924829
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jonathan Smith — President · (773) 985-8746
NPI enumeratedJuly 12, 2017
Last updated in NPPESJuly 12, 2017
Mailing address1641 W Farwell Ave Apt Nb, Chicago, IL 60626-6064

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