Provider Demographics
NPI:1417090432
Name:STEINBERG, MARK L (PHD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:L
Last Name:STEINBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4OO NORTH MCCLURG COURT
Mailing Address - Street 2:2903
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4346
Mailing Address - Country:US
Mailing Address - Phone:312-645-1931
Mailing Address - Fax:
Practice Address - Street 1:4OO NORTH MCCLURG COURT
Practice Address - Street 2:2903
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4346
Practice Address - Country:US
Practice Address - Phone:312-645-1931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical