Healthcare Provider Details

I. General information

NPI: 1245362789
Provider Name (Legal Business Name): KATHLEEN Q. STILLMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N MICHIGAN AVE SUITE 1015
CHICAGO IL
60601-7506
US

IV. Provider business mailing address

151 N MICHIGAN AVE SUITE 1015
CHICAGO IL
60601-7506
US

V. Phone/Fax

Practice location:
  • Phone: 312-938-8704
  • Fax: 312-266-2276
Mailing address:
  • Phone: 312-938-8704
  • Fax: 312-266-2276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: