Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1174014625 Individual Practitioner Male Practitioner

Dr. Robert Scott Waller , PsyD

Psychologist - Clinical • Chicago, IL

Professional Overview & Biography Verified Profile Summary

Dr. Robert Waller, PsyD is a registered healthcare professional specializing in Psychologist - Clinical in Chicago, IL. Practice services are available at 1276 N CLYBOURN AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1276 N Clybourn Ave

Chicago, IL 60610

Telephone 3123371073
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Clinical in Chicago, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.9 Yrs
State Avg: 24.2 Yrs
Regional Practice Density
1528 Specialists

Practicing in Chicago, IL (4140 Statewide)

Telehealth Adoption Rate
9.6% 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 071009689

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.

Psychologist - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 103TA0400X

State License IL 071009689

A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior.

Secondary Practice Locations

1525 E 53rd St Ste 623

Chicago, IL 606154530

Phone: 2392487437

30 N Michigan Ave Ste 529

Chicago, IL 606023491

Phone: 3126295075

Practice Associates & Co-Workers

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

40 Associated Practitioners
Andrew Koch , FNP

Nurse Practitioner - Family

NPI 1013499839

Family Nurse Practitioner

NPI 1063524502

Doctor of Medicine (M.D.)

Christina Smith , LCSW

Social Worker - Clinical

NPI 1124529896

Licensed Clinical Social Worker

NPI 1154186906

Doctor of Nursing Practice, Adult-Gerontology Nurse Practitioner (Certified)

Jakesha Rogers

Social Worker

NPI 1154210730
Sarah Nkwocha , APN

Nurse Practitioner - Family

NPI 1164909412

Advanced Practice Nurse

Career & Practice History Timeline

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

7 Historical Events
📍
Updated Practice Location September 05, 2018

Registered at 1276 N CLYBOURN AVE, CHICAGO, IL 60610 (Tel: 3123371073)

NPI Profile Active May 21, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location May 21, 2018

Registered at 1525 E 53RD ST STE 623, CHICAGO, IL 606154530 (Tel: 2392487437)

📍
Updated Business Mailing Address May 21, 2018

Registered at 1441 W ELMDALE AVE APT 1S, CHICAGO, IL 606602405 (Tel: 2392487437)

👤
Provider Name / Credentials Updated May 21, 2018

Recorded as ROBERT WALLER, PSYD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 21, 2018

Psychologist (License #071009689 in IL)

🟢
Initial NPI Registration & Enumeration May 21, 2018

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: 1174014625
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 21, 2018
Last Update: July 31, 2019
Sole Proprietor: No

Mailing Address

1441 W Elmdale Ave Apt 1s

Chicago, IL 606602405

Phone: 2392487437

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

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.