Provider Demographics
NPI:1376730028
Name:MARK D. PARISI, PSY.D., P.C.
Entity Type:Organization
Organization Name:MARK D. PARISI, PSY.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DOMINICK
Authorized Official - Last Name:PARISI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-909-9858
Mailing Address - Street 1:8053 N. KOLMAR AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076
Mailing Address - Country:US
Mailing Address - Phone:847-909-9858
Mailing Address - Fax:847-299-4952
Practice Address - Street 1:800 E NORTHWEST HWY STE 106
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-3457
Practice Address - Country:US
Practice Address - Phone:847-909-9858
Practice Address - Fax:847-299-4952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-005598261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)