Provider Demographics
NPI:1891825501
Name:STEHURA, EUGENE F (PHD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:F
Last Name:STEHURA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SKOKIE BLVD
Mailing Address - Street 2:107
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4039
Mailing Address - Country:US
Mailing Address - Phone:847-772-6440
Mailing Address - Fax:
Practice Address - Street 1:801 SKOKIE BLVD
Practice Address - Street 2:107
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4039
Practice Address - Country:US
Practice Address - Phone:847-772-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71-001783103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL644840Medicare ID - Type Unspecified