Active NPI
Allison Hayes Clarke, PH.D.
- Clinical Child & Adolescent Psychologist
- Park Ridge, IL
National Provider Identifier
1578015665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 071.009377
- Practice address
- 1775 Dempster St
Park Ridge, IL 60068-1143 - Phone
- (708) 917-9938
- NPI assigned
- Oct 25, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 071.009377 | IL | Primary |
Addresses
Primary practice location
1775 Dempster St
Park Ridge, IL 60068-1143
Mailing address
1775 Dempster St
Park Ridge, IL 60068-1143
Phone (708) 917-9938
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.009377 | IL | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477353600000",
"number": "1578015665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1775 DEMPSTER ST",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681143",
"telephone_number": "708-917-9938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 DEMPSTER ST",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681143",
"telephone_number": "708-917-9938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "ALLISON",
"middle_name": "HAYES",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-25",
"last_updated": "2016-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "IL",
"license": "071.009377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.