Individual
DR. DIANE STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
1101 LAKE ST, STE 405H, OAK PARK, IL 60301-1071
(708) 524-9513
(630) 604-1115
Mailing address
930 ONTARIO ST, APT 3C, OAK PARK, IL 60302-1938
(708) 302-5716
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071004319
IL
Other
Enumeration date
01/22/2007
Last updated
05/17/2016
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