Provider Demographics
NPI:1427071679
Name:RIPP, JOSEPH M (PSY D)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:RIPP
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 N PLUM GROVE RD
Mailing Address - Street 2:STE C
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4760
Mailing Address - Country:US
Mailing Address - Phone:847-413-9700
Mailing Address - Fax:847-413-1701
Practice Address - Street 1:919 N PLUM GROVE RD
Practice Address - Street 2:STE C
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4760
Practice Address - Country:US
Practice Address - Phone:847-413-9700
Practice Address - Fax:847-413-1701
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004907103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK22924Medicare UPIN
IL210811Medicare ID - Type Unspecified