Mary Anne Clark, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

7358 N Lincoln Ave Ste 170
Lincolnwood, IL 60712-1710

Phone

(773) 430-4601

NPI assigned

Dec 9, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• M. a. Clark, Inc

  • Clinical Psychologist
  • Lincolnwood, IL
  • NPI 1467634972
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1013077361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7358 N LINCOLN AVE STE 170",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121710",
            "telephone_number": "773-430-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7358 N LINCOLN AVE STE 170",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121710",
            "telephone_number": "773-430-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARY",
        "middle_name": "ANNE",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-09",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Choi
• Church Street Station Nursing
• Francisco L Chuy, M.D.
• Margarita Emilia Chuy, DMD
• Sabrina Cimo
• Megan Clark, BCBA
• Nathan Edward Clark, M.ED., BCBA
• Cassandra Coglianese
• Neli Cohen, PSYD
• Lora Collison, SLP-CCC

• Psychologist in Lincolnwood, IL
• Providers in Lincolnwood, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.