M. a. Clark, Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006752 Issued in IL

Legal business name

M. A. CLARK, INC

Practice address

7358 N Lincoln Ave Ste 170
Lincolnwood, IL 60712-1710

Phone

(773) 430-4601

NPI assigned

Nov 27, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Mary Anne Clark, PSY.DNPI 1013077361

Title

President

Phone

(773) 430-4601

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Anne Clark, PSY.D

  • Psychologist
  • Lincolnwood, IL
  • NPI 1013077361

  Clinical

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1467634972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7358 N LINCOLN AVE STE 170",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121710",
            "telephone_number": "773-430-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7358 N LINCOLN AVE STE 170",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121710",
            "telephone_number": "773-430-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. A. CLARK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-430-4601",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Lobue
• June Loredo
• Luxottica of America Inc.
• Rhianna Lynn
• Lyric National
• Issam Moussa Maatouk, M.D.
• Ruba M Maatouk, DDS
• Maison Trao Inc
• Elly Mak, M.D.
• Ayesha Malik

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.