Individual
DR. MARTIN M PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D. CADC MISA II
Contact information
Practice address
1780 MAPLE ST, NORTHFIELD, IL 60093-3021
(847) 446-7755
Mailing address
542 PINEWOOD DR, GLENCOE, IL 60022-1033
(847) 446-7755
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
#1186
IL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
#1459
MN
103TC0700X
Clinical Psychologist
#11830
CA
103TC0700X
Clinical Psychologist
Primary
071.007725
IL
Other
Enumeration date
05/12/2007
Last updated
07/31/2009
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