Verified record
Source: Illinois IDFPR license registry + NPPES. High trust.
Profession
Clinical Psychologist
IL license
071005990 — ACTIVE
Disciplinary record
On record — see detail below
NPI
1801852488 · matched by license
Pediatric
provider has not provided attestation
IDFPR disciplinary record · 2 actions on record
The Illinois Dept. of Financial & Professional Regulation (IDFPR) maintains a public record of disciplinary actions on professional licenses. The detail below is reproduced verbatim from the IDFPR licensing dataset — it is not a characterization by PedsList.
ProbationJul 15, 2025· IDFPR case 2022001535
Clinical psychology license has been suspended for 1 year to be followed by 3 years of probation as a result of, on or about September 14, 2018, the United States Department of Human Services excluded Respondent for 20 years from participating in any federal health care program for engaging in, "Fraud/Kickbacks/Other Prohibited Activities".
SuspensionJul 16, 2024· IDFPR case 2022001535
Clinical psychology license has been suspended for 1 year to be followed by 3 years of probation as a result of, on or about September 14, 2018, the United States Department of Human Services excluded Respondent for 20 years from participating in any federal health care program for engaging in, "Fraud/Kickbacks/Other Prohibited Activities".
Source: IDFPR license lookup · dataset data.illinois.gov / pzzh-kp68. Some actions are administrative (e.g. continuing-education or renewal lapses) and don't indicate patient harm; where wording reads "allegedly," it reflects allegations as recorded by IDFPR, not by itself a current finding of wrongdoing.
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