DR. MICHELLE TAN (PSYD) – Clinical Psychologist, NPI 1457956989

DR. MICHELLE TAN (PSYD) is a healthcare provider. based in Chicago, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. 071.010424 (IL). The NPI Number for DR. MICHELLE TAN (PSYD) is 1457956989

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHELLE TAN (PSYD)
NPI
1457956989
Phone
Not provided
Address
3633 N RAVENSWOOD
Enumeration Date
2 December 2020
Last Update Date
20 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8476860090
Graduation Year
2020 (6 years ago)
PAC ID
2961816061
Group Practice PAC ID
1355732777
Professional Enrollment ID
I20210202000058
Address ID
IL606113806CH160XXAVEX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for DR. MICHELLE TAN (PSYD)

  • 3633 N RAVENSWOOD

    CHICAGO, IL 60613

    Phone:

    Type: Mailing

  • 3633 N RAVENSWOOD AVE STE 1

    CHICAGO, IL 606133510

    Phone: (312) 730-4888

    Type: Location

  • 6 LOWER RAGSDALE DRIVE

    MONTEREY, CA 93940

    Phone:

    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: 2021-02-02

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
I20210202000058IClinical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90791Psychiatric diagnostic evaluation3219$0
View full utilization report →

Insurance plans in this area (ZIP 60613)

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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: 1355732777View full group profile
NameSpecialtyState
Clinical PsychologistIL
Clinical PsychologistMA
Clinical PsychologistMA
Clinical PsychologistIL
Clinical PsychologistIL
Clinical PsychologistIL
Clinical PsychologistIL
Clinical PsychologistIL

Reviews

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Frequently asked questions

How do I look up DR. MICHELLE TAN (PSYD) by NPI?
Use NPI 1457956989 when you need to reference DR. MICHELLE TAN (PSYD) in forms, claims, or directories.
Is DR. MICHELLE TAN (PSYD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does DR. MICHELLE TAN (PSYD) work in?
You can think of DR. MICHELLE TAN (PSYD) as practicing within Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where does public data place DR. MICHELLE TAN (PSYD)?
The snapshot lists Chicago, Illinois for DR. MICHELLE TAN (PSYD); download NPPES for the complete set.
Is DR. MICHELLE TAN (PSYD) a real provider?
This page reflects official NPPES data for NPI 1457956989. Always confirm identity and privileges with the practice and licensing boards.

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