DR. JEREMY TODD BIDWELL (PH.D.) – Prescribing (Medical) Psychologist, NPI 1609108703

DR. JEREMY TODD BIDWELL (PH.D.) is a healthcare provider. based in Woodstock, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 071.007831 (IL). The NPI Number for DR. JEREMY TODD BIDWELL (PH.D.) is 1609108703

Main info

Male
18 Years Of Experience
Accepts Medicare Assignment
Name
DR. JEREMY TODD BIDWELL (PH.D.)
NPI
1609108703
Phone
(815) 344-5061
Address
111 DEAN ST
Enumeration Date
1 February 2010
Last Update Date
15 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8478024058
Graduation Year
2008 (18 years ago)
PAC ID
3779609086
Group Practice PAC ID
6709128317
Professional Enrollment ID
I20100923001297
Address ID
IL600983220WO111XXSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:16State licenses:2Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for DR. JEREMY TODD BIDWELL (PH.D.)

  • 111 DEAN ST

    WOODSTOCK, IL 600983220

    Phone: (815) 344-5061

    Fax: (815) 344-5072

    Type: Mailing

  • 3923, Mercy Drive, McHenry, McHenry County, Illinois, 60050, United States

    SUITE F

    MCHENRY, IL 600503173

    Phone: (815) 344-5061

    Fax: (815) 344-5072

    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: 2010-09-23

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
I20100923001297IClinical 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 60098)

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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: 6709128317View full group profile
NameSpecialtyState
Clinical PsychologistIL
Mental Health CounselorIL
Clinical PsychologistIL
Mental Health CounselorIL
Clinical PsychologistIL
Clinical PsychologistIL
Clinical PsychologistIL
Mental Health CounselorIL
Mental Health CounselorIL
Mental Health CounselorIL

Reviews

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Frequently asked questions

Is there an official ID for DR. JEREMY TODD BIDWELL (PH.D.) in U.S. healthcare records?
The official identifier for DR. JEREMY TODD BIDWELL (PH.D.) is NPI 1609108703.
Is DR. JEREMY TODD BIDWELL (PH.D.) still an active registrant?
DR. JEREMY TODD BIDWELL (PH.D.) carries an active NPI according to the public dataset.
What area of care is associated with DR. JEREMY TODD BIDWELL (PH.D.)?
DR. JEREMY TODD BIDWELL (PH.D.)'s record emphasizes Prescribing (Medical) Psychologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. JEREMY TODD BIDWELL (PH.D.)?
Travel planning: use Woodstock, Illinois as the reference point for DR. JEREMY TODD BIDWELL (PH.D.), then confirm.
Can I trust this NPI listing for DR. JEREMY TODD BIDWELL (PH.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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