Individual provider Active NPI

Mark Thomas Sciarrino, PSY.D., MA

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1861763914
Registry record updated Jan 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008195 Issued in IL
Practice address
1925 N Milwaukee Ave
Chicago, IL 60647-4345
Phone
(773) 398-3698
NPI assigned
Jan 21, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071008195 IL Primary

Addresses

Primary practice location

1925 N Milwaukee Ave
Chicago, IL 60647-4345

Mailing address

1925 N Milwaukee Ave
Chicago, IL 60647-4345
Phone (773) 398-3698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 5, 2026 through Jan 5, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
071008195ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1327104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327104000000",
    "number": "1861763914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474345",
            "telephone_number": "773-398-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474345",
            "telephone_number": "773-398-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIARRINO",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PSY.D., MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-21",
        "last_updated": "2012-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.