Stacey Willard, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009205 Issued in IL

Practice address

150 S Wacker Dr Ste 2400
Chicago, IL 60606-4211

Phone

(312) 798-9078

NPI assigned

Dec 21, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1750746566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S WACKER DR STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606064211",
            "telephone_number": "312-798-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S WACKER DR STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606064211",
            "telephone_number": "312-798-9078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Broadway Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802024916",
            "country_code": "US",
            "telephone_number": "312-798-9078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "STACEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004654",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Zofia Wilkosz, R.D.
• Will Dempsey, Licsw, LLC
• Darren Will, MD
• Kenneth Ray Will, M.D.
• Barbara Allen Willard, RN, CNS
• Mark Aaron Wille, M.D.
• Tommy Richard Wille Jr.
• Jacob Willen
• Gary Alan Willer
• Janet Katherine Willer, PH.D.

• 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 Mar 17, 2018; 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.