Healthcare Provider Details

I. General information

NPI: 1992617021
Provider Name (Legal Business Name): JOHN STITT PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 TOUHY AVE STE 404
SKOKIE IL
60077-3227
US

IV. Provider business mailing address

5550 TOUHY AVE STE 404
SKOKIE IL
60077-3227
US

V. Phone/Fax

Practice location:
  • Phone: 847-329-9210
  • Fax:
Mailing address:
  • Phone: 847-329-9210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071.023417
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: