Individual provider Active NPI

Terry Ann Dornak Viloria, PSY.D.

  • Clinical Psychologist
  • Evanston, IL
National Provider Identifier
1902286974
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009088 Issued in IL
Practice address
1603 Orrington Ave
Evanston, IL 60201-3841
Phone
(872) 999-0542
Fax
(847) 972-6445
NPI assigned
Jun 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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 071009088 IL Primary

Addresses

Primary practice location

1603 Orrington Ave
Evanston, IL 60201-3841

Mailing address

8941 Marmora Ave
Morton Grove, IL 60053-2448
Phone (872) 999-0542

Other names 1

  • Terry Dornak Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160303001594 IL Practitioner - Clinical Psychologist 5890091680 Reassigns benefits to 1 organization
Practice locations: Chicago, IL
I20210927002072 FL Practitioner - Clinical Psychologist 5890091680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071009088ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
MB Clinical Psychology & Consulting, LLC Clinical PastSince Jan 27, 2016 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1902286974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8941 MARMORA AVE",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532448",
            "telephone_number": "872-999-0542",
            "fax_number": "847-972-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 ORRINGTON AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013841",
            "telephone_number": "872-999-0542",
            "fax_number": "847-972-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILORIA",
        "first_name": "TERRY ANN",
        "middle_name": "DORNAK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRY",
            "last_name": "DORNAK",
            "credential": "PSYD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.