JOHN KOH (PSY.D) – Clinical Psychologist, NPI 1720453160

JOHN KOH (PSY.D) is a healthcare provider. based in Evanston, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D. They hold a License No. 071009191 (IL). The NPI Number for JOHN KOH (PSY.D) is 1720453160

Main info

Male
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
JOHN KOH (PSY.D)
NPI
1720453160
Phone
(773) 234-9447
Address
708 CHURCH ST
Enumeration Date
10 December 2015
Last Update Date
23 December 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8478680310
Graduation Year
2011 (15 years ago)
PAC ID
1951650779
Group Practice PAC ID
0648364604
Professional Enrollment ID
I20180827003450
Address ID
IL602013881EV708XXSTXX303
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,603 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for JOHN KOH (PSY.D)

  • 708 CHURCH ST

    SUITE 216

    EVANSTON, IL 602013875

    Phone: (773) 234-9447

    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: 2018-08-27

PECOS data refreshed: 2026-06-15

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
I20180827003450IClinical 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 60201)

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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: 0648364604View full group profile
NameSpecialtyState
Clinical PsychologistIL
P S Y C H I A T R YIL

Reviews

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Frequently asked questions

What number should I use to identify JOHN KOH (PSY.D) for billing?
Administrative and clinical systems typically use NPI 1720453160 for JOHN KOH (PSY.D).
Does the public listing show JOHN KOH (PSY.D) as active?
JOHN KOH (PSY.D)'s NPI record reflects an active status in NPPES.
Which specialty label fits JOHN KOH (PSY.D)?
NPPES ties JOHN KOH (PSY.D) to Clinical Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to JOHN KOH (PSY.D)?
JOHN KOH (PSY.D) shows a connection to Evanston, Illinois in registry-derived data.
Who maintains JOHN KOH (PSY.D)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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