ETHAN ELLIOT STARK

CHICAGO, IL
NPI1730607771
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: IL  071.010910)
Enumeration Date2017-08-30
Last Update Date2023-06-08
Business Address
ETHAN ELLIOT STARK PsyD
3580 W MEDILL AVE APT 2
CHICAGO, IL 60647-2440
Phone number: 608-335-6705
Mailing Address
ETHAN ELLIOT STARK PsyD
70 S RIVER ST
AURORA, IL 60506-5185
Phone number: 630-844-2662
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