Active NPI
Audra Leigh Marks, PSY.D
- Clinical Psychologist
- Hoffman Estates, IL
National Provider Identifier
1114684347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.009113
- Practice address
- 1900 Hassell Rd
Health and Human Services
Hoffman Estates, IL 60169-6302 - Phone
- (847) 781-4850
- Fax
- (847) 781-4869
- NPI assigned
- Nov 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.009113 | IL | Primary |
Addresses
Primary practice location
1900 Hassell Rd
Health and Human Services
Hoffman Estates, IL 60169-6302
Mailing address
1900 Hassell Rd
Hoffman Estates, IL 60169-6302
Phone (847) 781-4850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE | Other | IL | NONE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hhs@hoffmanestates.org | Direct |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.009113 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1114684347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 HASSELL RD",
"city": "HOFFMAN ESTATES",
"state": "IL",
"postal_code": "601696302",
"telephone_number": "847-781-4850",
"fax_number": "847-781-4869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 HASSELL RD",
"address_2": "HEALTH AND HUMAN SERVICES",
"city": "HOFFMAN ESTATES",
"state": "IL",
"postal_code": "601696302",
"telephone_number": "847-781-4850",
"fax_number": "847-781-4869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "AUDRA",
"middle_name": "LEIGH",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-22",
"last_updated": "2021-11-22",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.009113",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "NONE",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hhs@hoffmanestates.org",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "mail",
"address_1": "1900 Hassell Road",
"address_2": "Health and Human Services",
"city": "Hoffman Estates",
"state": "IL",
"country_code": "US",
"postal_code": "60169",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hoffman Estates, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.