Provider Demographics
NPI:1487760393
Name:MARKIN, RICHARD A (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:MARKIN
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 1:7300 W COLLEGE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463
Mailing Address - Country:US
Mailing Address - Phone:708-448-8470
Mailing Address - Fax:708-448-9651
Practice Address - Street 1:7300 W COLLEGE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463
Practice Address - Country:US
Practice Address - Phone:708-448-8470
Practice Address - Fax:708-448-9651
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist