Provider Demographics
NPI:1790869493
Name:KIR-STIMON, MARGIT E (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARGIT
Middle Name:E
Last Name:KIR-STIMON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 CHURCH ST STE 422
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4580
Mailing Address - Country:US
Mailing Address - Phone:773-405-5573
Mailing Address - Fax:
Practice Address - Street 1:2025 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3280
Practice Address - Country:US
Practice Address - Phone:773-405-5573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003910103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001673541OtherBCBS
967820Medicare ID - Type Unspecified