Provider Demographics
NPI:1164815304
Name:MARK SILVEIRA, INC.
Entity Type:Organization
Organization Name:MARK SILVEIRA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:SILVEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-254-4663
Mailing Address - Street 1:440 W COLFAX ST
Mailing Address - Street 2:SUITE 445
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60078-7808
Mailing Address - Country:US
Mailing Address - Phone:847-254-4663
Mailing Address - Fax:
Practice Address - Street 1:440 W COLFAX ST
Practice Address - Street 2:SUITE 445
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60078-7808
Practice Address - Country:US
Practice Address - Phone:847-254-4663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009419101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty