Provider Demographics
NPI:1649219866
Name:BECKSTRAND, KAREN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:BECKSTRAND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:BECKSTRAND
Other - Last Name:STOUT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
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:847-550-0092
Mailing Address - Fax:
Practice Address - Street 1:1480 RENAISSANCE DR
Practice Address - Street 2:SUITE 212
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1332
Practice Address - Country:US
Practice Address - Phone:847-550-0092
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL997620Medicare ID - Type Unspecified