Healthcare Provider Details

I. General information

NPI: 1235408410
Provider Name (Legal Business Name): STEFANIE RAE WARD LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2011
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 HARRISON ST
OAK PARK IL
60304-1533
US

IV. Provider business mailing address

215 HARRISON ST
OAK PARK IL
60304-1533
US

V. Phone/Fax

Practice location:
  • Phone: 630-717-9408
  • Fax: 630-778-9490
Mailing address:
  • Phone: 708-628-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.000790
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: