Provider Demographics
NPI:1063667376
Name:HENRY, STAFFORD CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:STAFFORD
Middle Name:CHRISTOPHER
Last Name:HENRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 LEE ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4539
Mailing Address - Country:US
Mailing Address - Phone:847-795-3100
Mailing Address - Fax:847-795-3901
Practice Address - Street 1:701 LEE ST
Practice Address - Street 2:SUITE 800
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4539
Practice Address - Country:US
Practice Address - Phone:847-795-3100
Practice Address - Fax:847-795-3901
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.0841492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry