Wiliam Fraser Martin, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007396 Issued in VA

Practice address

4300 Commerce CT
300-3
Lisle, IL 60532-3698

Phone

(630) 393-9800

NPI assigned

Apr 18, 2007

Last updated

Dec 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Martin Lemon, PHD, P.C.

  dba Lemon, LiCavoli & Associates, P.C.

  • Clinical Psychologist
  • Warrenville, IL
  • NPI 1487779468
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1427274273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 HAMMAN WAY",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605024480",
            "telephone_number": "630-692-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 COMMERCE CT",
            "address_2": "300-3",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323698",
            "telephone_number": "630-393-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "WILIAM",
        "middle_name": "FRASER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "LA",
            "license": "614",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "IL",
            "license": "071006511",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Ann Markham Gonzalez
• Teresa Markum, LCPC
• April M Marlatt, ATC
• Christine Martin
• Stacey Marie Martin
• Martine Nelson, MD, LLC
• Philip Martinez, LCPC
• Madilyn Martus
• Ambareen Masood
• Sarah Masri, PA-C, CAQ PSYCHIATRY

• Clinical Psychologist in Lisle, IL
• Providers in Lisle, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.

Verify at the official NPI Registry.