Individual provider Active NPI

Hannah D Clark, PHD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1336055664
Registry record updated Aug 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.023156 Issued in IL
Practice address
1645 W Jackson Blvd Ste 400
Chicago, IL 60612-3244
Phone
(312) 942-8258
Fax
(312) 942-4990
NPI assigned
Aug 19, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2026

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 071.023156 IL Primary

Addresses

Primary practice location

1645 W Jackson Blvd Ste 400
Chicago, IL 60612-3244

Mailing address

1645 W Jackson Blvd
Chicago, IL 60612-3276
Phone (312) 942-8258

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

NPI Registry JSON

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787356800000",
    "number": "1336055664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123276",
            "telephone_number": "312-942-8258",
            "fax_number": "312-942-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123244",
            "telephone_number": "312-942-8258",
            "fax_number": "312-942-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "HANNAH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-22",
        "certification_date": "2026-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.023156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2026; 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.