Sharon Kim Black, PSYD is a medicare enrolled "Psychologist" provider in Oak Park, Illinois. She graduated from healthcare school in 2016 and has 9 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice Blackbird Behavioral Health Pc and her current practice location is
715 Lake St, Suite 706, Oak Park, Illinois. You can reach out to her office (for appointments etc.) via phone at
(773) 991-6375.
Sharon Kim Black is licensed to practice in Illinois (license number 071.009658) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1407094915.
Healthcare Provider's Profile
| Full Name | Sharon Kim Black |
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| Gender | Female |
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| Speciality | Clinical Psychologist |
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| Experience | 9 Years |
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| Location | 715 Lake St, Oak Park, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Sharon Kim Black graduated from medical school in 2016
NPI Data:
- NPI Number: 1407094915
- Provider Enumeration Date: 01/22/2009
- Last Update Date: 11/04/2019
Medicare PECOS Information:
- PECOS PAC ID: 0749228922
- Enrollment ID: I20180427001969
Medical Identifiers
Medical identifiers for Sharon Kim Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1407094915 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YP2500X | Counselor - Professional | 180.004472 (Illinois) | Secondary |
| 103T00000X | Psychologist | 071.009658 (Illinois) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Blackbird Behavioral Health Pc | 4284998212 | 3 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sharon Kim Black allows following entities to bill medicare on her behalf.
| Entity Name | Blackbird Behavioral Health Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245748722
PECOS PAC ID: 4284998212
Enrollment ID: O20180427001868 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sharon Kim Black is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Sharon Kim Black, PSYD
633 Carpenter Ave,
Oak Park, IL 60304-1104
Ph: (773) 991-6375 | Sharon Kim Black, PSYD
715 Lake St, Suite 706,
Oak Park, IL 60301-1422
Ph: (773) 991-6375 |
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