Mary Elizabeth Avellone, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071005023 Issued in IL

Practice address

2024 Hickory Rd Ste 104
Homewood, IL 60430-2158

Phone

(312) 832-9858

Fax

(312) 822-0712

NPI assigned

Jun 16, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1699770693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E OHIO ST APT 520",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113220",
            "telephone_number": "312-832-9858",
            "fax_number": "708-365-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 HICKORY RD STE 104",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302158",
            "telephone_number": "312-832-9858",
            "fax_number": "312-822-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVELLONE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005023",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071005023",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "1607451",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.