Individual
DR. TRACY BISTERFELDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
53 W. JACKSON BLVD., UNIT 635, CHICAGO, IL 60604
(414) 379-2959
Mailing address
934 N. GROVE AVE., OAK PARK, IL 60302
(414) 379-2959
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.008187
IL
Other
Enumeration date
10/25/2011
Last updated
10/25/2019
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