Individual
MR. GERALD M. STEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
210 W 22ND ST, SUITE 118, OAK BROOK, IL 60523-1544
(630) 571-1077
Mailing address
210 W 22ND ST, SUITE 118, OAK BROOK, IL 60523-1544
(630) 571-1077
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
071-001939
IL
103TC0700X
Clinical Psychologist
Primary
071-001939
IL
103TH0100X
Health Service Psychologist
071-001939
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022-72048-74
BLUE CROSS BLUE SHIELD
IL
01
—
071-001939
LICENSE
IL
Enumeration date
01/28/2007
Last updated
11/13/2008
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