Organization
DR. STACY ELLIS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY ELLIS PH. D. (LICENSED CLINICAL PSYCHOLOGIST)
(323) 228-7746
Entity
Organization
Contact information
Practice address
1900 OGDEN AVE STE 106, AURORA, IL 60504-4284
(630) 405-7265
Mailing address
PO BOX 398, WINFIELD, IL 60190-0398
(323) 228-7746
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
01/25/2020
Last updated
01/25/2020
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