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PARKSIDE PSYCHOLOGICAL SERVICES, LLC
NPI 1295100485
Psychologist - Clinical in Lake Forest, IL

Active since December 14, 2015
840 S WAUKEGAN RD STE 203, LAKE FOREST, IL 60045(847) 420-5088 Get Directions Write a Review

NPPES record last updated: June 7, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 7, 2021, May 18, 2021, Mar 28, 2016 and 2 more (5 updates tracked since 2015).

About Parkside Psychological Services, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PARKSIDE PSYCHOLOGICAL SERVICES, LLC (NPI 1295100485) is a healthcare organization registered as a clinical in Lake Forest, Illinois and active in the NPI registry since December 2015. The organization lists Paul Smiley, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1295100485
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NamePARKSIDE PSYCHOLOGICAL SERVICES, LLC
Location Address840 S WAUKEGAN RD STE 203Lake Forest, IL 60045-2619
Mailing Address840 S Waukegan Rd Ste 203Lake Forest, IL 60045-2619 · (847) 420-5088
Phone(847) 420-5088
Organization SubpartNo
Authorized OfficialPaul SmileyClinical Psychologist · (847) 420-5088
Enumeration DateDecember 14, 2015
Last NPPES UpdateJune 7, 20215 updates tracked since enumeration
NPPES CertifiedJune 7, 2021
✔ NPI 1295100485 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IL · 071.007555
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
840 S WAUKEGAN RD STE 203, Lake Forest, IL 60045
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Parkside Psychological Services, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Parkside Psychological Services, LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Paul Smiley, PSY.D., ABCP
Clinical Psychologist
NPI 1588861579
840 S WAUKEGAN RD STE 203
Lake Forest, IL 60045
(847) 420-5088
✔ PECOS5.2 mi
Maja Jakovljevic, PSYD
Clinical Psychologist
NPI 1811728322
540 W FRONTAGE RD STE 2320
Northfield, IL 60093
(708) 613-0377
✔ PECOS15 mi
Jill Sanderson-Davis, LCSW
Clinical Social Worker
NPI 1063664787
2314 SWAINWOOD DR
Glenview, IL 60025
(847) 999-3893
✔ PECOS16 mi
Sharon Song, PH.D.
Clinical Psychologist
NPI 1912983651
909 E PALATINE RD
Palatine, IL 60074
(847) 776-1400
✔ PECOS16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Parkside Psychological Services, LLC's NPI number?

The NPI number for Parkside Psychological Services, LLC is 1295100485. It was assigned to this organization in the NPPES registry on December 14, 2015.

Where is Parkside Psychological Services, LLC located?

Parkside Psychological Services, LLC is located at 840 S Waukegan Rd Ste 203, Lake Forest, IL 60045. The listed phone number is (847) 420-5088.

What is Parkside Psychological Services, LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Parkside Psychological Services, LLC enrolled in Medicare?

Yes. Parkside Psychological Services, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Parkside Psychological Services, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Parkside Psychological Services, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Psychologist (3) and Clinical Social Worker (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Parkside Psychological Services, LLC was last updated on June 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.