JOHN HARDIE PHD CLINICAL PSYCHOLOGIST LLC
NPI 1629649157
Psychologist - Clinical in Northbrook, IL

Q: What is John Hardie Phd Clinical Psychologist LLC's specialty?

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

Active since July 06, 2021

85 REVERE DR STE G, NORTHBROOK, IL 60062(847) 559-9343(773) 913-2395 Get Directions Write a Review

NPPES record last updated: July 6, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About John Hardie Phd Clinical Psychologist Llc NPPES

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

JOHN HARDIE PHD CLINICAL PSYCHOLOGIST LLC (NPI 1629649157) is a healthcare organization registered as a clinical in Northbrook, Illinois and active in the NPI registry since July 2021. The organization maintains a secondary practice location in Chicago and lists Yesenia Servin, Credentialing Mananger, as its authorized official.

NPPES Registry Identity

NPI1629649157

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameJOHN HARDIE PHD CLINICAL PSYCHOLOGIST LLC

Location Address85 REVERE DR STE GNorthbrook, IL 60062-8001

Mailing Address85 Revere Dr Ste GNorthbrook, IL 60062-8001 · (847) 559-9343 · Fax (773) 913-2395

Phone(847) 559-9343

Fax(773) 913-2395

Organization SubpartNo

Authorized OfficialYesenia ServinCredentialing Mananger · (708) 979-9082

Enumeration DateJuly 6, 2021

NPPES CertifiedJuly 6, 2021

✔ NPI 1629649157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

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.

Also ListedPsychologist · Health ServiceTaxonomy 103TH0100X

85 REVERE DR STE G, Northbrook, IL 60062

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Secondary Practice Location 1

Location 12800 N Sheridan Rd Ste 108Chicago, IL 60657-6183 · Phone (847) 559-9343

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

John Hardie Phd Clinical Psychologist Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to John Hardie Phd Clinical Psychologist LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

John Hardie, PH.D.

Clinical Psychologist

NPI 1376732255

85 REVERE DRIVE SUITE 108
Chicago, IL 60657

(847) 559-9343

✔ PECOS25 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 John Hardie Phd Clinical Psychologist LLC's NPI number?

The NPI number for John Hardie Phd Clinical Psychologist LLC is 1629649157. It was assigned to this organization in the NPPES registry on July 6, 2021.

Where is John Hardie Phd Clinical Psychologist LLC located?

John Hardie Phd Clinical Psychologist LLC is located at 85 Revere Dr Ste G, Northbrook, IL 60062. The listed phone number is (847) 559-9343.

What is John Hardie Phd Clinical Psychologist LLC's specialty?

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

Is John Hardie Phd Clinical Psychologist LLC enrolled in Medicare?

Yes. John Hardie Phd Clinical Psychologist LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through John Hardie Phd Clinical Psychologist LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to John Hardie Phd Clinical Psychologist 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for John Hardie Phd Clinical Psychologist LLC was last updated on July 6, 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.