Individual
DR. MARK A MOULTHROP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
636 CHURCH ST, SUITE 407, EVANSTON, IL 60201-4508
(847) 869-3702
(847) 869-8945
Mailing address
636 CHURCH ST, SUITE 407, EVANSTON, IL 60201-4508
(847) 869-3702
(847) 869-8945
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
IL
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
01/24/2007
Last updated
09/11/2025
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