Provider Demographics
NPI:1639449911
Name:EDGESON-STEINER, TAWANA L (PSY D)
Entity Type:Individual
Prefix:DR
First Name:TAWANA
Middle Name:L
Last Name:EDGESON-STEINER
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5494
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-5304
Mailing Address - Country:US
Mailing Address - Phone:630-627-1700
Mailing Address - Fax:
Practice Address - Street 1:6502 JOLIET RD
Practice Address - Street 2:
Practice Address - City:COUNTRYSIDE
Practice Address - State:IL
Practice Address - Zip Code:60525-4682
Practice Address - Country:US
Practice Address - Phone:708-215-8405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007656103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical