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

Pcpa Legacy, LLC

Organization Clinical Psychologist · NPI 1093030132

Pcpa Legacy, LLC is a Clinical Psychologist in Northbrook, Illinois. Licensed in Illinois. Registered with an NPI since 2010.

Licensed in
IL
In the registry since
2010
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

400 Skokie Blvd Ste 245
Northbrook, IL 60062-7932
Phone: (847) 630-1611
Fax: (847) 446-4673
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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 071-004395 (IL)
Clinical Child & Adolescent Psychologist Taxonomy 103TC2200X · Licence 071-004395 (IL)

Record details

NPI number1093030132
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Kredow — Provider/Owner · (847) 630-1611
Other names Pcpa Legacy. Llc; Primary Care Psychology Assocaites, Llc
NPI enumeratedApril 1, 2010
Last updated in NPPESSeptember 6, 2023
Certification dateOctober 27, 2022
Mailing address400 Skokie Blvd Ste 245, Northbrook, IL 60062-7932

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