KELLY BAUMAN (PSY.D) – Clinical Psychologist, NPI 1174802730
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,600 CLINICAL PSYCHOLOGIST in IL
Provider Addresses for KELLY BAUMAN (PSY.D)
360 STATION DR STE 100
CRYSTAL LAKE, IL 600147994
Phone: (815) 338-6600
Fax: (815) 356-2324
Type: Mailing
457 COVENTRY LN STE 115
CRYSTAL LAKE, IL 600147571
Phone: (815) 245-4825
Fax: (815) 596-1008
Type: Location
3703 Doty Rd
Woodstock, IL 600987517
Phone: (800) 765-9999
Fax: (815) 206-2822
Type: Location
360 Station Dr Ste 100
Crystal Lake, IL 60014
Phone: (815) 338-6600
Fax: (815) 356-2324
Type: Location
720 S EASTWOOD DR STE 166
WOODSTOCK, IL 600984635
Phone: (815) 245-4825
Fax: (815) 596-1008
Type: Mailing
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: 2015-03-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150311000286 | I | Clinical Psychologist | IL | 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 60014)
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