Provider Demographics
NPI:1619947520
Name:TURNER, MARK W (PSY D)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:W
Last Name:TURNER
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 STONEGATE RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1914
Mailing Address - Country:US
Mailing Address - Phone:847-577-1155
Mailing Address - Fax:847-577-3858
Practice Address - Street 1:139 STONEGATE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1914
Practice Address - Country:US
Practice Address - Phone:847-577-1155
Practice Address - Fax:847-577-3858
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01627973OtherBLUE CROSS
IL01627973OtherBLUE CROSS
575890Medicare ID - Type Unspecified
S17164Medicare UPIN