Healthcare Provider Details

I. General information

NPI: 1942936661
Provider Name (Legal Business Name): CAMERON STAMM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 W INSTITUTE PL STE 500
CHICAGO IL
60610-8792
US

IV. Provider business mailing address

213 W INSTITUTE PL STE 500
CHICAGO IL
60610-8792
US

V. Phone/Fax

Practice location:
  • Phone: 312-847-4421
  • Fax:
Mailing address:
  • Phone: 312-847-4421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.012180
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: