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ALEXANDER KYLE TATUM
NPI 1316435423
Psychologist - Clinical in Chicago, IL

Active since April 24, 2018Opted out of Medicare · through Jun 4, 2027
5412 N CLARK ST STE 212, CHICAGO, IL 60640(773) 257-3606 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Feb 2, 2026, Apr 24, 2018 (2 updates tracked since 2018).

About Alexander Kyle Tatum NPPES

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

ALEXANDER KYLE TATUM (NPI 1316435423) is an individual clinical provider in Chicago, Illinois, licensed in Illinois (071.010516) and active in the NPI registry since April 2018. He has opted out of Medicare through June 4, 2027.

NPPES Registry Identity

NPI1316435423
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameALEXANDER KYLE TATUM
Location Address5412 N CLARK ST STE 212Chicago, IL 60640-1273
Mailing Address5412 N Clark St Ste 212Chicago, IL 60640-1273 · (434) 284-3806
Phone(773) 257-3606
Sole ProprietorNo
Enumeration DateApril 24, 2018
Last NPPES UpdateFebruary 2, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2026
✔ NPI 1316435423 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 · 071.010516
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.
5412 N CLARK ST STE 212, Chicago, IL 60640
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Alexander Kyle Tatum has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 4, 2021 through June 4, 2027.

Opt-Out Effective DateJune 4, 2021
Opt-Out In Effect ThroughJune 4, 2027Opt-out affidavits renew automatically every two years unless cancelled

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 Alexander Tatum's NPI number?

The NPI number for Alexander Tatum is 1316435423. It was assigned to this individual provider in the NPPES registry on April 24, 2018.

Where is Alexander Tatum located?

Alexander Tatum practices at 5412 N Clark St Ste 212, Chicago, IL 60640. The listed phone number is (773) 257-3606.

What is Alexander Tatum's specialty?

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

Is Alexander Tatum enrolled in Medicare?

No. Alexander Tatum has opted out of Medicare through June 4, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Alexander Tatum was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.