DR. JERRY MARK OTOOLE PSYD
NPI 1790393650
Psychologist in Plainfield, IL

Active since July 16, 2020PECOS EnrolledAccepts Medicare Assignment
24402 W LOCKPORT ST STE 215, PLAINFIELD, IL 60544(630) 621-5824 Get Directions Write a Review

NPPES record last updated: August 29, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jerry Mark Otoole Psyd NPPES

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

DR. JERRY MARK OTOOLE PSYD (NPI 1790393650) is an individual psychologist in Plainfield, Illinois, licensed in Illinois (071006413) and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1790393650
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. JERRY MARK OTOOLECredential: PSYD
Location Address24402 W LOCKPORT ST STE 215Plainfield, IL 60544-4204
Mailing Address12816 Timber Wood CirPlainfield, IL 60585-2974 · (240) 449-5170
Sole ProprietorYes
Medical School CMSOtherGraduated 2000
Enumeration DateJuly 16, 2020
Last NPPES UpdateAugust 29, 2024
NPPES CertifiedAugust 29, 2024
NPI 1790393650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in IL · 071006413
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.
24402 W LOCKPORT ST STE 215, Plainfield, IL 60544

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Jerry Mark Otoole Psyd 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 ID6608294475
PECOS Enrollment IDI20200910000699
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

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

Counselor (Professional)
24402 W LOCKPORT ST STE 215
PLAINFIELD, IL 60544

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 Jerry Otoole's NPI number?

The NPI number for Jerry Otoole is 1790393650. It was assigned to this individual provider in the NPPES registry on July 16, 2020.

Where is Jerry Otoole located?

Jerry Otoole practices at 24402 W Lockport St Ste 215, Plainfield, IL 60544. The listed phone number is (630) 621-5824.

What is Jerry Otoole's specialty?

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

Is Jerry Otoole enrolled in Medicare?

Yes. Jerry Otoole 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 Jerry Otoole was last updated on August 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.