Organization Name: | MARK E SHARP PHD PC |
NPI Number: | 1033387451 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK E SHARP (CLINICAL PSYCHOLOGIST) |
Mailing Address: | 1010 Jorie Blvd Suite 246 Oak Brook |
State: | IL US |
Postal Code: | 605232215 |
Phone Number: | 6302306358 |
Fax Number: | 6302306359 |
NPI Enumeration Date: | 02/19/2008 |
NPI Last Update Date: | 02/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |