THEODORE POLONUS PHD
NPI 1891858239
Psychologist in Chicago, IL

Active since December 18, 2006Opted out of Medicare · through Apr 2, 2028
333 E ONTARIO ST APT 1703B, CHICAGO, IL 60611(312) 543-5780 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Theodore Polonus Phd NPPES

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

THEODORE POLONUS PHD (NPI 1891858239) is an individual psychologist in Chicago, Illinois and active in the NPI registry since December 2006. He has opted out of Medicare through April 2, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1891858239
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameTHEODORE POLONUSCredential: PHD
Location Address333 E ONTARIO ST APT 1703BChicago, IL 60611-4871
Mailing Address333 E Ontario St Apt 1703bChicago, IL 60611-4871 · (312) 543-5780
Sole ProprietorYes
Enumeration DateDecember 18, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1891858239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
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.
333 E ONTARIO ST APT 1703B, Chicago, IL 60611

Other Identifiers 2

OtherBLUE CROSSIL · 01673341
Medicare ID-Type Unspecified202586IL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Theodore Polonus Phd 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 April 2, 2016 through April 2, 2028.

Opt-Out Effective DateApril 2, 2016
Opt-Out In Effect ThroughApril 2, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

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

Psychologist
333 E ONTARIO ST APT 1703B
CHICAGO, IL 60611

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 Theodore Polonus's NPI number?

The NPI number for Theodore Polonus is 1891858239. It was assigned to this individual provider in the NPPES registry on December 18, 2006.

Where is Theodore Polonus located?

Theodore Polonus practices at 333 E Ontario St Apt 1703B, Chicago, IL 60611. The listed phone number is (312) 543-5780.

What is Theodore Polonus's specialty?

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

Is Theodore Polonus enrolled in Medicare?

No. Theodore Polonus has opted out of Medicare through April 2, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Theodore Polonus was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.