Active NPI
Mark Wayne Conard, PHD
- Clinical Psychologist
- Olympia Fields, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 71007282
- Practice address
- 20201 Crawford Ave
Olympia Fields, IL 60461-1010 - Phone
- (708) 756-1000
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20042160A | IN | |
| Clinical Psychologist | 103TC0700X | 71007282 | IL | Primary |
Addresses
Primary practice location
20201 Crawford Ave
Olympia Fields, IL 60461-1010
Mailing address
300 Randall Rd Ste 100
Geneva, IL 60134-4200
Phone (630) 938-8266
Other practice location 1
300 Randall Rd Ste 100
Geneva, IL 60134-4200
Phone (630) 938-8266
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1637305 | Other | IL | BLUE CROSS BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mconard68111@Direct.FranciscanAlliance.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
- 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, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 933-4700
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.63 of 100
- Quality
- 88.47
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71007282 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Current | Accepting new patients | |
| Central Dupage Physician Group | Current | Accepting new patients |
Locations
Carol Stream, IL 60122
Phone (630) 933-3300
Dept 5777
Carol Stream, IL 60122
300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009
300 Randall Rd
Ste 100
Geneva, IL 60134
Phone (630) 933-3513
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
Interoperability endpoints
- mconard68111@direct.franciscanalliance.org
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.
-
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
-
- Orthopaedic Surgery Physician
- Geneva, IL
- NPI 1780012344
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Geneva, IL
- NPI 1407859655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1912012626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 RANDALL RD STE 100",
"city": "GENEVA",
"state": "IL",
"postal_code": "601344200",
"telephone_number": "630-938-8266",
"fax_number": "630-938-2110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20201 CRAWFORD AVE",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611010",
"telephone_number": "708-756-1000"
}
],
"practiceLocations": [
{
"address_1": "300 Randall Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Geneva",
"state": "IL",
"postal_code": "601344200",
"country_code": "US",
"telephone_number": "630-938-8266",
"fax_number": "630-938-2110",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CONARD",
"first_name": "MARK",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20042160A",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "71007282",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1637305",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mconard68111@Direct.FranciscanAlliance.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "20201 Crawford Ave",
"city": "Olympia Fields",
"state": "IL",
"country_code": "US",
"postal_code": "604611010",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Olympia Fields, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.