NPIMap

Organization Active NPI

Donna Marino, Psy.D., LTD

  • Clinical Psychologist
  • Oak Park, IL
National Provider Identifier
1184991507
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071006816 Issued in IL
Legal business name
DONNA MARINO, PSY.D., LTD
Practice address
1101 Lake St
Suite 310
Oak Park, IL 60301-1085
Phone
(773) 882-0373
Fax
(708) 524-8758
NPI assigned
Nov 30, 2011
Last updated
Nov 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Authorized official

Name
Donna Marino, PSY.D.NPI 1053427963
Title
Owner
Phone
(773) 882-0373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071006816 IL Primary

Addresses

Primary practice location

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

Mailing address

P.O. Box 613
Channahon, IL 60410-0613
Phone (815) 521-1889

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1184991507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 613",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604100613",
            "telephone_number": "815-521-1889",
            "fax_number": "815-521-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 LAKE ST",
            "address_2": "SUITE 310",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011085",
            "telephone_number": "773-882-0373",
            "fax_number": "708-524-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA MARINO, PSY.D., LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "MARINO",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-882-0373",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.