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

Dr. Michael Richard Black, PSYD

Individual provider Psychologist · NPI 1699061390

Dr. Michael Richard Black, PSYD is a Clinical Psychologist in Chicago, Illinois. Qualified in 2007, 19 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
19
Licensed in
IL
In the registry since
2011
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

3139 N Lincoln Ave Ste 221
Chicago, IL 60657-3122
Phone: (773) 458-0585
Fax: (999) 999-9999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 071008134 (IL)

Record details

NPI number1699061390
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorYes
NPI enumeratedJune 22, 2011
Last updated in NPPESMay 13, 2022
Certification dateMay 13, 2022

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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