DR. DANIEL POLONSKY (PSY.D.) – Clinical Psychologist, NPI 1174335111

DR. DANIEL POLONSKY (PSY.D.) is a healthcare provider. based in Northbrook, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. They hold a License No. 03351 (KS). The NPI Number for DR. DANIEL POLONSKY (PSY.D.) is 1174335111

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
DR. DANIEL POLONSKY (PSY.D.)
NPI
1174335111
Phone
(847) 449-6084
Address
1916 DEERCREST LN
Enumeration Date
27 January 2025
Last Update Date
10 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6304248900
Graduation Year
2023 (3 years ago)
PAC ID
9638696156
Group Practice PAC ID
5799881488
Professional Enrollment ID
I20250508001017
Address ID
IL601484880LO477XXRDXX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:1State licenses:2Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for DR. DANIEL POLONSKY (PSY.D.)

  • 1916 DEERCREST LN

    NORTHBROOK, IL 600625074

    Phone: (847) 449-6084

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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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: 2025-05-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250508001017IClinical PsychologistILTBD

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.

Verify on CMS Revalidation Lookup Tool

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 60062)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799881488View full group profile
NameSpecialtyState
Clinical Social WorkerVA
Clinical PsychologistIL

Reviews

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Frequently asked questions

Can I cross-check DR. DANIEL POLONSKY (PSY.D.) using NPI 1174335111?
NPI 1174335111 belongs to DR. DANIEL POLONSKY (PSY.D.); compare other details if you need extra assurance.
Would DR. DANIEL POLONSKY (PSY.D.) appear as active to a payer?
You can treat DR. DANIEL POLONSKY (PSY.D.) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. DANIEL POLONSKY (PSY.D.)?
DR. DANIEL POLONSKY (PSY.D.)'s record emphasizes Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is DR. DANIEL POLONSKY (PSY.D.) associated with Northbrook?
Public fields place DR. DANIEL POLONSKY (PSY.D.) around Northbrook, Illinois. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for DR. DANIEL POLONSKY (PSY.D.) is noted as January 27, 2025 where the registry provides it.

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