Individual provider Active NPI

Mark Lloyd Goldstein, PHD

  • Forensic Psychologist
  • Highland Park, IL
National Provider Identifier
1154424471
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
712066 Issued in IL
Practice address
1893 Sheridan Rd
Suite 215
Highland Park, IL 60035
Phone
(847) 926-0390
Fax
(847) 498-8922
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 712066 IL
Forensic Psychologist 103TF0200X 712066 IL Primary

Addresses

Primary practice location

1893 Sheridan Rd
Suite 215
Highland Park, IL 60035

Mailing address

1893 Sheridan Rd
Suite 215
Highland Park, IL 60035
Phone (847) 926-0390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
712066ILMDForensic Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1154424471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 SHERIDAN RD",
            "address_2": "SUITE 215",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "60035",
            "telephone_number": "847-926-0390",
            "fax_number": "847-498-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 SHERIDAN RD",
            "address_2": "SUITE 215",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "60035",
            "telephone_number": "847-926-0390",
            "fax_number": "847-498-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "MARK",
        "middle_name": "LLOYD",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "712066",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "IL",
            "license": "712066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.