NPIMap

Organization Active NPI

Stacey Max, Psy.D.

  • Clinical Psychologist
  • Lincolnshire, IL
National Provider Identifier
1205108826
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.005848 Issued in IL
Legal business name
STACEY MAX, PSY.D.
Practice address
250 Parkway Dr
Suite 150
Lincolnshire, IL 60069-4322
Phone
(847) 275-5589
NPI assigned
Jan 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Authorized official

Name
Dr. Stacey Max, PSY.D.
Title
Clinical Psychologist
Phone
(847) 275-5589

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 071.005848 IL Primary

Addresses

Primary practice location

250 Parkway Dr
Suite 150
Lincolnshire, IL 60069-4322

Mailing address

250 Parkway Dr
Suite 150
Lincolnshire, IL 60069-4322
Phone (847) 275-5589

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1205108826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PARKWAY DR",
            "address_2": "SUITE 150",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600694322",
            "telephone_number": "847-275-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARKWAY DR",
            "address_2": "SUITE 150",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600694322",
            "telephone_number": "847-275-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACEY MAX, PSY.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "MAX",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "847-275-5589",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.005848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnshire, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.