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Individual

DR. KELLY RISTAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
640 N RIVER RD STE 108, NAPERVILLE, IL 60563-8947
(630) 718-0717
Mailing address
PO BOX 4555, NAPERVILLE, IL 60567-4555

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.009856
IL
103TF0200X
Forensic Psychologist
071.009856
IL

Other

Enumeration date
09/14/2022
Last updated
04/02/2025
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