Stefanie Maxwell, Psy.D., P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-006622 Issued in IL

Legal business name

STEFANIE MAXWELL, PSY.D., P.C.

Practice address

4305 N Lincoln Ave
Office J
Chicago, IL 60618-1711

Phone

(773) 316-1488

Fax

(773) 271-4562

NPI assigned

Oct 4, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Stefanie Maxwell, PSY.D.NPI 1245390947

Title

President

Phone

(773) 316-1488

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stefanie Maxwell, PSY. D.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1245390947
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1689958050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 N LINCOLN AVE",
            "address_2": "OFFICE J",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181711",
            "telephone_number": "773-316-1488",
            "fax_number": "773-271-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 N LINCOLN AVE",
            "address_2": "OFFICE J",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181711",
            "telephone_number": "773-316-1488",
            "fax_number": "773-271-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEFANIE MAXWELL, PSY.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-316-1488",
        "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": "071-006622",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "071-006622",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Rose Stefancic, B.S.
• Michael Florian Stefancic, M.D.
• Steven James Stefani
• Amie Stefanich, LCSW
• Stefanie Dominik LLC
• Kristina Noemi Stefanini
• Vasilios John Stefanis, MD
• Jennifer Stefankiewicz
• Margaret Stefanowski
• Anne Stefanski-Douglas, MS, CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.