Marlys a Conrad PHD LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

071003676 Issued in IL

Legal business name

MARLYS A CONRAD PHD LLC

Practice address

918 Michigan Ave
Apt 1
Evanston, IL 60202-1494

Phone

(847) 624-7446

NPI assigned

Sep 16, 2015

Last updated

Sep 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marlys A Conrad, PHD

Title

Owner

Phone

(847) 624-7446

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1821467218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 MICHIGAN AVE",
            "address_2": "APT 1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021494",
            "telephone_number": "847-624-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 MICHIGAN AVE",
            "address_2": "APT 1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021494",
            "telephone_number": "847-624-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLYS A CONRAD PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "MARLYS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-624-7446",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "071003676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "071003676",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Borzecka, DDS, Corp
• Carlos Alberto Marin, MD
• Mark D Gendleman MD SC
• Angela Mark, MD
• Dara J Marlin
• Deborah S Marmor, DMD
• Anne Marous, LCSW
• Demetrios Peter Maroutsos, MD
• Amy Lynn-Engfer Marr
• Monika Marrero, APRN

• Professional Counselor in Evanston, IL
• Providers in Evanston, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.