DR. COLIN A. BRIETZKE PSY. D.
NPI 1558626267
Clinical Neuropsychologist in Oak Park, IL

Active since July 09, 2012PECOS EnrolledAccepts Medicare Assignment
1011 LAKE ST STE 200, OAK PARK, IL 60301(708) 320-1441 Get Directions Write a Review

NPPES record last updated: May 7, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 7, 2024, Jun 23, 2021 (2 updates tracked since 2021).

About Dr. Colin A. Brietzke Psy. D. NPPES

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

DR. COLIN A. BRIETZKE PSY. D. (NPI 1558626267) is an individual clinical neuropsychologist in Oak Park, Illinois, licensed in Illinois (071.008376) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1558626267
Entity TypeIndividualMale
Primary Taxonomy103G00000X
Provider Legal NameDR. COLIN A. BRIETZKECredential: PSY. D.
Location Address1011 LAKE ST STE 200Oak Park, IL 60301-1137
Mailing Address1011 Lake St Ste 200Oak Park, IL 60301-1137 · (708) 320-1411 · Fax (708) 328-3560
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateJuly 9, 2012
Last NPPES UpdateMay 7, 20242 updates tracked since enumeration
NPPES CertifiedMay 7, 2024
NPI 1558626267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License Licensed in IL · 071.008376
Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 071008376 (IL)
Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X · License 071008376 (IL)
Also ListedPsychologist · ForensicTaxonomy 103TF0200X · License 071.008376 (IL)
1011 LAKE ST STE 200, 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

Dr. Colin A. Brietzke 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 ID749586428
PECOS Enrollment IDI20160307000512
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


The following 4 providers are registered at the same or a nearby location.

Social Worker (Clinical)
1011 LAKE ST STE 200
OAK PARK, IL 60301
Psychologist (Clinical)
1011 LAKE ST STE 200
OAK PARK, IL 60301
Psychologist (Clinical Child & Adolescent)
1011 LAKE ST STE 200, 200
OAK PARK, IL 60301
Psychologist
1011 LAKE ST STE 200
OAK PARK, IL 60301

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1558626267, enumerated as an "individual" on July 09, 2012.

The provider is located at 1011 LAKE ST STE 200 OAK PARK, IL 60301 and the phone number is (708) 320-1441.

Clinical Neuropsychologist with taxonomy code 103G00000X.