Organization
STEFANIE MAXWELL, PSY.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEFANIE MAXWELL PSY.D. (PRESIDENT)
(773) 316-1488
Entity
Organization
Contact information
Practice address
4305 N LINCOLN AVE, OFFICE J, CHICAGO, IL 60618-1711
(773) 316-1488
(773) 271-4562
Mailing address
4305 N LINCOLN AVE, OFFICE J, CHICAGO, IL 60618-1711
(773) 316-1488
(773) 271-4562
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-006622
IL
251S00000X
Community/Behavioral Health Agency
071-006622
IL
Other
Enumeration date
10/04/2011
Last updated
10/04/2011
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