Provider Demographics
NPI:1578610804
Name:SHARP, MARK E (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:SHARP
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1010 JORIE BLVD
Mailing Address - Street 2:SUITE 246
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2215
Mailing Address - Country:US
Mailing Address - Phone:630-230-6358
Mailing Address - Fax:630-230-6359
Practice Address - Street 1:1010 JORIE BLVD
Practice Address - Street 2:SUITE 246
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2215
Practice Address - Country:US
Practice Address - Phone:630-230-6358
Practice Address - Fax:630-230-6359
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical