Individual provider Active NPI

Marissa Davis

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1134795362
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.176674 Issued in IL
Practice address
1 E Superior St Ste 306
Chicago, IL 60611-2595
Phone
(312) 754-9404
NPI assigned
May 28, 2021
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 81525-20 WI
Psychiatry Physician 2084P0800X 036.176674 IL Primary

Addresses

Primary practice location

1 E Superior St Ste 306
Chicago, IL 60611-2595

Mailing address

8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022003422 IL Practitioner - Psychiatry 5092110007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clarity Clinic LLCGroup PAC ID 7517284755, 110 clinicians

Practice addresses (Care Compare)

333 N Michigan Ave
Suite 1400
Chicago, IL 60601-4011
Phone (312) 815-9660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036.176674ILMDPsychiatry Physician
8866WIMDFamily Nurse Practitioner
81525-20WIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Clinic PLLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

333 N Michigan Ave
Ste 1400
Chicago, IL 60601
Phone (312) 815-9660

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

NPI Registry JSON

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1134795362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 W WATERTOWN PLANK RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E SUPERIOR ST STE 306",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112595",
            "telephone_number": "312-754-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "81525-20",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.176674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.