Shiraz Tata PHD LLC
NPI 1083109524 · Clinical Psychologist · Rockford, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shiraz Tata PHD LLC is a Clinical Psychologist organization in Rockford, IL (NPI 1083109524).
Provider details
- NPI number
- 1083109524
- Entity type
- Organization
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Shiraz Tata, Licensed Clinical Psychologist(815) 519-2949
- License
- 071.04963 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- Shiraz P. Tata
Registry dates
- Enumerated
- 2018-06-27
- Last updated
- 2018-08-01
Frequently asked questions
- What is Shiraz Tata PHD LLC's NPI number?
- Shiraz Tata PHD LLC's National Provider Identifier (NPI) is 1083109524, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shiraz Tata PHD LLC?
- Shiraz Tata PHD LLC is classified in the NPPES registry as Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Shiraz Tata PHD LLC located?
- Shiraz Tata PHD LLC's practice location on file with NPPES is 6072 Brynwood Dr Ste 107, Rockford, IL 61114.
- What is Shiraz Tata PHD LLC's phone number?
- The practice phone number listed in the NPPES registry for Shiraz Tata PHD LLC is (815) 519-2949.
- Does Shiraz Tata PHD LLC accept Medicare?
- Shiraz Tata PHD LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Shiraz Tata PHD LLC?
- The authorized official listed on Shiraz Tata PHD LLC's NPPES record is Shiraz Tata, Licensed Clinical Psychologist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shiraz Tata PHD LLC's NPI active?
- Yes — Shiraz Tata PHD LLC's NPI (1083109524) is active in the NPPES registry as of the last update on 2018-08-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.