Individual
DR. STACY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1900 OGDEN AVE STE 106, AURORA, IL 60504-4284
(630) 405-7265
(630) 256-8009
Mailing address
PO BOX 398, WINFIELD, IL 60190-0398
(323) 228-7746
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.010228
IL
Other
Enumeration date
01/28/2008
Last updated
03/09/2020
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