Healthcare Provider Details

I. General information

NPI: 1245790096
Provider Name (Legal Business Name): BROOKE STENGLEIN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E TOUHY AVE STE 250
DES PLAINES IL
60018-3339
US

IV. Provider business mailing address

PO BOX 772263
DETROIT MI
48277-2263
US

V. Phone/Fax

Practice location:
  • Phone: 800-693-1916
  • Fax:
Mailing address:
  • Phone: 224-875-0595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071009956
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: