Active NPI
Marlin Coppock Hoover, PHD
- Clinical Psychologist
- Tinley Park, IL
National Provider Identifier
1831175298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071003290
- Practice address
- 16325 Harlem Ave
Suite 200
Tinley Park, IL 60477-2509 - Phone
- (708) 429-6999
- Fax
- (708) 429-6909
- NPI assigned
- Dec 19, 2005
- Last updated
- Nov 26, 2007
- Sex
- Male
- 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 Psychologist | 103TC0700X | 071003290 | IL | Primary |
Addresses
Primary practice location
16325 Harlem Ave
Suite 200
Tinley Park, IL 60477-2509
Mailing address
16325 Harlem Ave
Suite 200
Tinley Park, IL 60477-2509
Phone (708) 429-6999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1960 N Solano Dr
Suite RXP
Las Cruces, NM 88001-1858
Phone (575) 571-1571
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071003290 | IL | MD | Clinical Psychologist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Hoover & Associates
- Clinical Psychologist
- Tinley Park, IL
- NPI 1871578625
NM
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196035200000",
"number": "1831175298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16325 HARLEM AVE",
"address_2": "SUITE 200",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604772509",
"telephone_number": "708-429-6999",
"fax_number": "708-429-6909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16325 HARLEM AVE",
"address_2": "SUITE 200",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604772509",
"telephone_number": "708-429-6999",
"fax_number": "708-429-6909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOVER",
"first_name": "MARLIN",
"middle_name": "COPPOCK",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-19",
"last_updated": "2007-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071003290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.