Dr. Bradley C Stolbach
Clinical Child & Adolescent Psychologist
6700 S. Promontory Drive
Chicago
, Illinois 60649
Dr. Bradley C Stolbach
Clinical Child & Adolescent Psychologist
6700 S. Promontory Drive
Chicago
, Illinois 60649
(773) 256-5735
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About
Features
Specialties
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Dr. Bradley C Stolbach
- 6700 S. Promontory Drive
- Chicago, IL
- Zip : 60649
- Phone : (773) 256-5735
Second Address
- Dr. Bradley C Stolbach
- 6700 S. Promontory Drive
- Chicago, IL
- Zip : 60649
- Phone : (773) 256-5735
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC2200X | Clinical Child & Adolescent Psychologist | IL |
National Provider Identifier
| NPI | 1114113487 |
|---|---|
| Provider Name | Dr. Bradley C Stolbach |
| First Address | Chicago, IL 60649 |
| Second Address | Chicago, IL 60649 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/09/2007 |
| Last Update Date | 20/09/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.