Provider Demographics
NPI:1649418518
Name:DONNA LETTIERI-MARKS, PSY.D., LTD
Entity Type:Organization
Organization Name:DONNA LETTIERI-MARKS, PSY.D., LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LETTIERI-MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-904-6610
Mailing Address - Street 1:55 S MAIN ST
Mailing Address - Street 2:SUITE 371
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5372
Mailing Address - Country:US
Mailing Address - Phone:630-904-6610
Mailing Address - Fax:630-544-3429
Practice Address - Street 1:55 S MAIN ST
Practice Address - Street 2:SUITE 371
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5372
Practice Address - Country:US
Practice Address - Phone:630-904-6610
Practice Address - Fax:630-544-3429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-005423261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1346233665OtherNPI (INDIVIDUAL TYPE I NUMBER)
IL357980OtherMEDICARE