KATHERINE ANNE DEBROECK, Psy.D. — NPI 1720914237 (Licensed & Credentialed Clinical Neuropsychologist in RIVERWOODS, IL)

CMS-1500 Box 24J / 33a • NPI

1720914237

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103G00000X

Licensed & Credentialed Clinical Neuropsychologist

Box 32 Service Location & ZIP+4

2610 LAKE COOK RD STE 133, RIVERWOODS, IL, 60015-5710

✓ 9-Digit EDI 837 ZIP+4 (60015-5710)

Practice Phone & Referral Fax

(847) 920-7187

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1720914237 (KATHERINE ANNE DEBROECK, Psy.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1720914237` (NPI-1 Individual Practitioner)
Provider / Legal Name	KATHERINE ANNE DEBROECK, Psy.D.
Plain-English Specialty	Licensed & Credentialed Clinical Neuropsychologist NUCC Code: `103G00000X` (Clinical Neuropsychologist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2610 LAKE COOK RD STE 133, RIVERWOODS, IL, 60015-5710
Practice Telephone / Fax	Tel: (847) 920-7187
Administrative Mailing Address	2610 LAKE COOK RD STE 133, RIVERWOODS, IL, 60015-5710
Enumeration & Last Sync	Enumerated: 2026-06-22 \| CMS Record Updated: 2026-06-22

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2610 LAKE COOK RD STE 133, RIVERWOODS, IL, 60015-5710

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Plain-English Taxonomy & CMS Crosswalk (103G00000X)

What Does Taxonomy Code 103G00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103G00000X translates to:
"Licensed & Credentialed Clinical Neuropsychologist"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Clinical Neuropsychologist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KATHERINE ANNE DEBROECK, Psy.D.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103G00000X` — Clinical Neuropsychologist Plain English: Licensed & Credentialed Clinical Neuropsychologist	State: IL \| License: `071.022705` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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KATHERINE ANNE DEBROECK, Psy.D. (NPI #1720914237)