Mary A Lee, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071-004127 Issued in IL

Practice address

2555 Lincoln Hwy
Ste. 108C
Olympia Fields, IL 60461-1936

Phone

(708) 983-8030

Fax

(708) 283-2544

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1871640052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 LINCOLN HWY",
            "address_2": "#167",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432316",
            "telephone_number": "708-983-8030",
            "fax_number": "708-283-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 LINCOLN HWY",
            "address_2": "STE. 108C",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611936",
            "telephone_number": "708-983-8030",
            "fax_number": "708-283-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071-004127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl-Erik Larsen, ATC
• Gregory Laurenzana, RN
• Cassidy Mae Lawler
• Phillip Le, D.O.
• Ryan Leahy, D.O.
• Noah Thomas Lee, D.O.
• Caniece Leggett
• Jennifer Lema, D.O.
• Devan Whittington Lenhart, DO
• Carl Leonhardt, DO

• Psychologist in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.