Individual
STEPHANIE FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-6953
Mailing address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071.009655
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071.009655
ILLINOIS DEPT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
11/15/2017
Last updated
11/15/2017
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