Organization
ENVISION PSYCHOLOGICAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN M STASEK PSYD (CLINICAL PSYCHOLOGIST)
(815) 388-9071
Entity
Organization
Contact information
Practice address
1100 COUGAR TRL, CARY, IL 60013-6057
(815) 388-9071
(847) 516-2510
Mailing address
3221 MIDLANE DR, WADSWORTH, IL 60083-9457
(815) 388-9071
(847) 516-2510
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071005965
IL
Other
Enumeration date
11/29/2010
Last updated
11/29/2010
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