Provider Demographics
NPI:1205253762
Name:MARKS, VICTORIA (PSYD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:MARKS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 RIVER BEND RD STE 400A
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5263
Mailing Address - Country:US
Mailing Address - Phone:630-661-0253
Mailing Address - Fax:
Practice Address - Street 1:475 RIVER BEND RD STE 400A
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5263
Practice Address - Country:US
Practice Address - Phone:630-661-0253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-23
Last Update Date:2014-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006305103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical