Individual
MARK TIMOTHY STEINHAUSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
259 E ERIE ST, CHICAGO, IL 60611
(312) 695-6868
Mailing address
680 N LAKE SHORE DR, CHICAGO, IL 60611-4546
(312) 695-6868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007152
IL
363A00000X
Physician Assistant
1163429
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1163429
NATIONAL CERTIFICATION ON THE COMMISSION OF PHYSICIAN ASSISTANTS (NCCPA)
—
Enumeration date
05/28/2019
Last updated
07/30/2021
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