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Pcpa Legacy, LLC

Clinical Psychologist in Northbrook, IL · enumerated 2010 · authorized official Paul Kredow, Provider/Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1093030132

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Registry record

Entity type Organization (Type 2)
Legal business name Pcpa Legacy, LLC
Other name <Unavail>
Practice address 400 Skokie Blvd Ste 245, Northbrook, IL, 60062
Phone (847) 630-1611
Fax (847) 446-4673
Enumeration date Apr 1, 2010
Last updated in NPPES Sep 6, 2023

Taxonomy & classification

103TC0700X Clinical Psychologist Behavioral Health & Social Service Providers · License 071-004395 (IL) Primary
103TC2200X Clinical Child & Adolescent Psychologist Behavioral Health & Social Service Providers · License 071-004395 (IL) Secondary

Authorized official

Name Paul Kredow
Title Provider/Owner
Phone (847) 630-1611

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Pcpa Legacy, LLC?
The NPI for Pcpa Legacy, LLC is 1093030132, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Pcpa Legacy, LLC?
NPPES lists Paul Kredow (Provider/Owner) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-09-06.