SHARON KIM BLACK PSY.D.
NPI 1407094915
Psychologist in Oak Park, IL

Active since January 22, 2009PECOS EnrolledAccepts Medicare Assignment
715 LAKE ST, SUITE 706, OAK PARK, IL 60301(773) 991-6375 Get Directions Write a Review

NPPES record last updated: November 4, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sharon Kim Black Psy.d. NPPES

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

SHARON KIM BLACK PSY.D. (NPI 1407094915) is an individual psychologist in Oak Park, Illinois, licensed in Illinois (071.009658) and active in the NPI registry since January 2009. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1407094915
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameSHARON KIM BLACKCredential: PSY.D.
Location Address715 LAKE ST, SUITE 706Oak Park, IL 60301-1422
Mailing Address633 Carpenter AveOak Park, IL 60304-1104 · (773) 991-6375
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateJanuary 22, 2009
Last NPPES UpdateNovember 4, 2019
NPI 1407094915 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in IL · 071.009658
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 180.004472 (IL)
715 LAKE ST, Oak Park, IL 60301

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Sharon Kim Black Psy.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749228922
PECOS Enrollment IDI20180427001969
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
715 LAKE ST
OAK PARK, IL 60301
Pharmacy (Community/Retail Pharmacy)
715 LAKE ST
OAK PARK, IL 60301
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
715 LAKE ST
OAK PARK, IL 60301
Clinic/Center (Family Planning, Non-Surgical)
715 LAKE ST, SUITE 273
OAK PARK, IL 60301
Advanced Practice Midwife
715 LAKE ST, SUITE 273
OAK PARK, IL 60301
Dentist (General Practice)
715 LAKE ST, SUITE 300
OAK PARK, IL 60301
Social Worker (Clinical)
715 LAKE ST, SUITE 720
OAK PARK, IL 60301
Naprapath
715 LAKE ST
OAK PARK, IL 60301

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 Sharon Black's NPI number?

The NPI number for Sharon Black is 1407094915. It was assigned to this individual provider in the NPPES registry on January 22, 2009.

Where is Sharon Black located?

Sharon Black practices at 715 Lake St Suite 706, Oak Park, IL 60301. The listed phone number is (773) 991-6375.

What is Sharon Black's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Sharon Black enrolled in Medicare?

Yes. Sharon Black is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Sharon Black was last updated on November 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.