Provider Demographics
NPI:1528025616
Name:STOUT, CHRIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:STOUT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22918 N WOODCREST CT
Mailing Address - Street 2:
Mailing Address - City:KILDEER
Mailing Address - State:IL
Mailing Address - Zip Code:60047-7844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 TIMBERLINE DR
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-3848
Practice Address - Country:US
Practice Address - Phone:630-257-9600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical