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

Individual provider Clinical Psychologist · NPI 1174608400

Dr. Dathan A. Paterno, PSYD is a Clinical Psychologist in Park Ridge, Illinois. Qualified in 2003, 23 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
23
Licensed in
IL
In the registry since
2006
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

36 Main St Ste 106
Park Ridge, IL 60068-4059
Phone: (847) 692-6692
Fax: (847) 692-6685
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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 071.006986 (IL)

Record details

NPI number1174608400
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorYes
NPI enumeratedOctober 26, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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