Organization
SUNSTONE PSYCHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS JOSEPH FORMICA PH.D. (LICENSED CLINICAL PSYCHOLOGIST)
(312) 625-7352
Entity
Organization
Contact information
Practice address
6119 N KENMORE AVE APT 202, CHICAGO, IL 60660-2704
(312) 625-7352
Mailing address
6119 N KENMORE AVE APT 202, CHICAGO, IL 60660-2704
(330) 348-1198
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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