Individual provider Active NPI

Marie Chesaniuk, PHD

  • Clinical Psychologist
  • Skokie, IL
National Provider Identifier
1417816422
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.011465 Issued in IL
Practice address
4711 Golf Rd Ste 520
Skokie, IL 60076-1208
Phone
(847) 966-9343
NPI assigned
Jan 16, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 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 071.011465 IL Primary

Addresses

Primary practice location

4711 Golf Rd Ste 520
Skokie, IL 60076-1208

Mailing address

4711 Golf Rd Ste 520
Skokie, IL 60076-1208

Other practice location 1

1620 W 18th St
Chicago, IL 60608-2836
Phone (312) 772-5369

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.011465ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Cognitive Behavioral Treatment Center Clinical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1768521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1417816422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 520",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 520",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761208",
            "telephone_number": "847-966-9343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 W 18th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606082836",
            "country_code": "US",
            "telephone_number": "312-772-5369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHESANIUK",
        "first_name": "MARIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-01-16",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.011465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.