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Deactivated NPI 1043230220 Deactivated / Inactive NPI Male Practitioner

Dr. Robert E Ingraham , PsyD

Psychologist - Clinical • Aurora, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Ingraham has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 20, 2006
NPI Deactivation Date June 10, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Ingraham, PsyD was a registered Psychologist - Clinical practicing in Aurora, IL. Throughout an active medical career spanning 15 years, Dr. Ingraham provided care at the practice location at 412 N LAKE ST until profile deactivation on 2021-06-10.

Practice Location & Contact Primary Location

Practice Address

412 N Lake St
# 202

Aurora, IL 605064106

Telephone 6308194421
Fax 6308972760
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Clinical in Aurora, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.2 Yrs
State Avg: 24.2 Yrs
Regional Practice Density
31 Specialists

Practicing in Aurora, IL (4140 Statewide)

Telehealth Adoption Rate
19.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist - Clinical Primary Specialty

NUCC Taxonomy Code: 103TC0700X

State License IL 071-004122

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
NPI 1033435342

Licensed Clinical Professional Counselor

Susan Kinsman , LCPC

Counselor - Mental Health

NPI 1134616352

Licensed Clinical Professional Counselor

Monica Sisco , LCSW

Counselor - Mental Health

NPI 1154488294

Licensed Clinical Social Worker

Dr. Charlotte Dillon , PhD

Psychologist - Clinical

NPI 1326114562

Doctor of Philosophy (Ph.D.)

Tiffany Green , MAPC

Counselor - Professional

NPI 1346768413
Kerry O'donnell , LPC

Counselor - Professional

NPI 1417333287

Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 10, 2021

Record deactivated on June 10, 2021

NPI Profile Active December 20, 2010

NPI status registered as active in NPPES database

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Updated Practice Location December 20, 2010

Registered at 412 N LAKE ST, # 202, AURORA, IL 605064106 (Tel: 6308194421)

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Updated Business Mailing Address December 20, 2010

Registered at 412 N LAKE ST, # 202, AURORA, IL 605064106 (Tel: 6308194421)

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Provider Name / Credentials Updated December 20, 2010

Recorded as ROBERT INGRAHAM, PSY.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 20, 2010

Psychologist (License #071-004122 in IL)

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Initial NPI Registration & Enumeration July 20, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1043230220
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 20, 2006
Last Update: December 20, 2010
Deactivation Date: June 10, 2021

Mailing Address

412 N Lake St, # 202

Aurora, IL 605064106

Phone: 6308194421

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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