Dr. Jeffry Wayne Stine
Clinical Psychologist Clinical Child & Adolescent Psychologist
900 Skokie Blvd Ste 115
Northbrook
, Illinois 60062
Dr. Jeffry Wayne Stine
Clinical Psychologist Clinical Child & Adolescent Psychologist
900 Skokie Blvd Ste 115
Northbrook
, Illinois 60062
(847) 929-4513
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About
Features
Specialties
- Clinical Psychologist
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Dr. Jeffry Wayne Stine
- 2450 W Addison St Apt 2a
- Chicago, IL
- Zip : 60618-5960
- Fax : (847) 929-4513
- Phone : (224) 388-3633
Second Address
- Dr. Jeffry Wayne Stine
- 900 Skokie Blvd Ste 115
- Northbrook, IL
- Zip : 60062
- Fax : (847) 929-4513
- Phone : (224) 388-3633
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 071008039 | IL |
| Y | 103TC0700X | Clinical Psychologist | 071008039 | IL |
| N | 103TC2200X | Clinical Child & Adolescent Psychologist | 071008039 | IL |
National Provider Identifier
| NPI | 1083912034 |
|---|---|
| Provider Name | Dr. Jeffry Wayne Stine |
| First Address | Chicago, IL 60618-5960 |
| Second Address | Northbrook, IL 60062 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/02/2011 |
| Last Update Date | 24/06/2019 |
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.