Provider Demographics
NPI:1326898800
Name:OIL DOCTOR PSYD LLC
Entity Type:Organization
Organization Name:OIL DOCTOR PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:STELTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:224-242-0672
Mailing Address - Street 1:1462 FARGO BLVD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2979
Mailing Address - Country:US
Mailing Address - Phone:224-242-0672
Mailing Address - Fax:
Practice Address - Street 1:1462 FARGO BLVD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2979
Practice Address - Country:US
Practice Address - Phone:224-242-0672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No305S00000XManaged Care OrganizationsPoint of Service