Healthcare Provider Details

I. General information

NPI: 1306822630
Provider Name (Legal Business Name): TIMOTHY STERZIK PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 W BRYN MAWR AVE FORSTER COUNSELING
CHICAGO IL
60631-3570
US

IV. Provider business mailing address

1249 WOOD ST
DEERFIELD IL
60015-2947
US

V. Phone/Fax

Practice location:
  • Phone: 773-695-0900
  • Fax: 773-695-0700
Mailing address:
  • Phone: 847-236-1840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: