{"npi":"1083342299","type":"NPI-2","status":"active","name":{"display":"Riverside Psychology","other":[],"organization_name":"RIVERSIDE PSYCHOLOGY","authorised_official":"Megan Baldassarre"},"specialty":{"primary_taxonomy":"103G00000X","primary_taxonomy_description":"Clinical Neuropsychologist","slug":"clinical-neuropsychologist","schema_org_specialty":null,"all":[{"code":"103G00000X","description":"Clinical Neuropsychologist","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"7627 LAKE ST STE 222","city":"RIVER FOREST","state":"IL","postal_code":"603051806","country_code":"US","phone":"7087629602"},{"purpose":"MAILING","street_1":"7627 LAKE ST STE 222","city":"RIVER FOREST","state":"IL","postal_code":"603051806","country_code":"US","phone":"7087629602"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20221119000549","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"IL","pac_id":"4587032719"}]},"enumeration_date":"2022-08-15","last_updated":"2022-10-21","_meta":{"source":"NPPES","snapshot_date":"2022-10-21","doc_url":"https://findmynpi.com/api"}}