Mark Solomon, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-003896 Issued in IL

Practice address

128 Newberry Ave
Libertyville, IL 60048-1923

Phone

(847) 680-0272

Fax

(847) 360-1615

NPI assigned

Aug 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1649289620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 NEWBERRY AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481923",
            "telephone_number": "847-680-0272",
            "fax_number": "847-680-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 NEWBERRY AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481923",
            "telephone_number": "847-680-0272",
            "fax_number": "847-360-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-003896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Lauren Smith, MA LCPC
• Michelle Smith
• Rachael Teal Smith, EMT-P
• Cassandra Leigh Snider, PA-C
• Carla Marie Solomon
• Linda M Sommercorn, MS, DDS, RPH
• Sonamu Wellness LLC
• Jie Song, M.D.
• Anshuman Soni, DDS
• Wilfred E Soppe, CRNA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.