DR. SHANNON MARIE BALABAN (PHD) – Clinical Psychologist, NPI 1093425985
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,600 CLINICAL PSYCHOLOGIST in IL
Provider Addresses for DR. SHANNON MARIE BALABAN (PHD)
1860 W Winchester Rd Ste 106
Libertyville, IL 600485312
Phone: (847) 816-6335
Type: Location
4600 Green Bay Rd
Kenosha, WI 531441719
Phone: (262) 286-1860
Type: Location
9327 N 3RD ST STE 200
PHOENIX, AZ 850202473
Phone: (520) 595-5500
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240430004345 | I | Clinical Psychologist | AZ | TBD |
| I20240513003639 | I | Clinical Psychologist | IL | TBD |
| I20240515003012 | I | Clinical Psychologist | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60048)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| Clinical Psychologist | ME | |
| Psychiatry, Psychiatry, Neurology, Neurology | IL | |
| Clinical Social Worker | WI | |
| Nurse Practitioner | AZ | |
| Clinical Psychologist | IL | |
| Mental Health Counselor | IL | |
| Physician Assistant | IL | |
| P S Y C H I A T R Y | AR | |
| Nurse Practitioner | WI |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.