1346233665 NPI number — DR. DONNA LETTIERI-MARKS PSY.D.

Table of content: DR. DONNA LETTIERI-MARKS PSY.D. (NPI 1346233665)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346233665 NPI number — DR. DONNA LETTIERI-MARKS PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LETTIERI-MARKS
Provider First Name:
DONNA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346233665
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
55 S MAIN ST
Provider Second Line Business Mailing Address:
SUITE 371
Provider Business Mailing Address City Name:
NAPERVILLE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60540-5372
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-904-6610
Provider Business Mailing Address Fax Number:
630-544-3429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
55 S MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 371
Provider Business Practice Location Address City Name:
NAPERVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60540-5372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-904-6610
Provider Business Practice Location Address Fax Number:
630-544-3429
Provider Enumeration Date:
08/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 50521 . This is a "NATIONAL REGISTER" identifier . This identifiers is of the category "OTHER".




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