Jeffry Wayne Stine, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071008039 Issued in IL

Practice address

900 Skokie Blvd Ste 115
Northbrook, IL 60062

Phone

(224) 388-3633

Fax

(847) 929-4513

NPI assigned

Feb 28, 2011

Last updated

Jun 24, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Jeffry Stine Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1083912034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W ADDISON ST APT 2A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185960",
            "telephone_number": "224-388-3633",
            "fax_number": "847-929-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SKOKIE BLVD STE 115",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60062",
            "telephone_number": "224-388-3633",
            "fax_number": "847-929-4513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6935 W Touhy Ave",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "IL",
            "postal_code": "607144521",
            "country_code": "US",
            "telephone_number": "224-388-3633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Skokie Blvd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "60062",
            "country_code": "US",
            "telephone_number": "224-388-3633",
            "fax_number": "847-929-4513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STINE",
        "first_name": "JEFFRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-28",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008039",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071008039",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEFFRY",
            "last_name": "STINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Steven D. Field, M.D. S. C.
• Steven E. Rothke, PH.D., PC
• Katherine Stewart, LCPC
• William Robert Stiles, M.D.,J.D.
• Matthew R Stinde
• Lori Stlaurent
• Michael Alan Stock, LSW
• Julie Stocking
• Montrele Quinton Stokes
• Shanika L Stokes

• Clinical Psychologist in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.