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Individual

DR. STACEY WILLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
150 S WACKER DR STE 2400, CHICAGO, IL 60606-4211
(312) 798-9078
Mailing address
150 S WACKER DR STE 2400, CHICAGO, IL 60606-4211
(312) 798-9078

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.009205
IL
103TC0700X
Clinical Psychologist
PSY.0004654
CO

Other

Enumeration date
12/21/2015
Last updated
03/17/2018
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