Individual provider Active NPI

Marlene Brusko, PSY.D

  • Clinical Psychologist
  • Schaumburg, IL
National Provider Identifier
1013091016
Registry record updated May 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
71003717 Issued in IL
Practice address
814 Beacon Dr
Schaumburg, IL 60193-3834
Phone
(847) 991-9996
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 71003717 IL Primary

Addresses

Primary practice location

814 Beacon Dr
Schaumburg, IL 60193-3834

Mailing address

814 Beacon Dr
Schaumburg, IL 60193-3834
Phone (847) 991-9996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
71003717ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Marlene Brusko Psy.D. Clinical PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306627200000",
    "number": "1013091016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 BEACON DR",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933834",
            "telephone_number": "847-991-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 BEACON DR",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933834",
            "telephone_number": "847-991-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSKO",
        "first_name": "MARLENE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "71003717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.