Organization
MILLENNIUM PARK PSYCHOLOGICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDITH K. STUHR PHD (AUTHORIZED OFFICIAL/MEMBER)
(312) 284-1330
Entity
Organization
Contact information
Practice address
30 N MICHIGAN AVE, SUITE 1103, CHICAGO, IL 60602-3402
(312) 284-1330
(312) 284-1331
Mailing address
30 N MICHIGAN AVE, SUITE 1103, CHICAGO, IL 60602-3402
(312) 284-1330
(312) 284-1331
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634734
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/17/2006
Last updated
06/06/2008
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