Donna M Marino, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071006816 Issued in IL

Practice address

1101 Lake St
Ste 310
Oak Park, IL 60301-1085

Phone

(773) 882-0373

Fax

(708) 524-8758

NPI assigned

Aug 22, 2006

Last updated

Nov 2, 2011By the provider in NPPES

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

Other identifiers 1

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marcia S. Gibson, Psy.D and Associates, P. C.Group PAC ID 2365577160, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Marcia S. Gibson, Psy.D and Associates, P. C..

  • Adolescent and Children Mental Health Clinic/Center
  • Bolingbrook, IL
  • NPI 1881922284
  Medicare reassignment Care Compare group NPD
• Donna Marino, Psy.D., LTD

  • Clinical Psychologist
  • Oak Park, IL
  • NPI 1184991507
  NPD (past) Authorized official

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1053427963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 LAKE ST",
            "address_2": "STE 310",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011085",
            "telephone_number": "773-882-0373",
            "fax_number": "708-524-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 LAKE ST",
            "address_2": "STE 310",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011085",
            "telephone_number": "773-882-0373",
            "fax_number": "708-524-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "DONNA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071006816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01623882",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mari Mortensen LCSW PLLC
• Maria Cecilia Dahn, M.D.
• Maria Slobodian MD SC
• Nora Mariduena, PSYD
• Anthony M Marinelli, MD
• Leslie A Marino, AM MSW LCSW
• Marion Street Dental LTD
• Lauren Marion, FNP
• Angel Markin, LCPC CADC
• Anna Marotti

• Psychologist in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.