Individual provider Active NPI

Eugene F Stehura, PH.D.

  • Clinical Psychologist
  • Northbrook, IL
National Provider Identifier
1891825501
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
71-001783 Issued in IL
Practice address
801 Skokie Blvd
107
Northbrook, IL 60062-4039
Phone
(847) 772-6440
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 71-001783 IL Primary

Addresses

Primary practice location

801 Skokie Blvd
107
Northbrook, IL 60062-4039

Mailing address

801 Skokie Blvd
107
Northbrook, IL 60062-4039
Phone (847) 772-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
71-001783ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891825501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SKOKIE BLVD",
            "address_2": "107",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624039",
            "telephone_number": "847-772-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SKOKIE BLVD",
            "address_2": "107",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624039",
            "telephone_number": "847-772-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEHURA",
        "first_name": "EUGENE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "71-001783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.