Individual
DR. JEFFRY WAYNE STINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
900 SKOKIE BLVD STE 115, NORTHBROOK, IL 60062
(224) 388-3633
(847) 929-4513
Mailing address
2450 W ADDISON ST APT 2A, CHICAGO, IL 60618-5960
(224) 388-3633
(847) 929-4513
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008039
IL
103TC2200X
Clinical Child & Adolescent Psychologist
071008039
IL
Other
Enumeration date
02/28/2011
Last updated
06/24/2019
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