Provider Demographics
NPI:1922631449
Name:WEINSTOCK, FRAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRAN
Middle Name:
Last Name:WEINSTOCK
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 1:450 E WATERSIDE DR UNIT 802
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-4709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE
Practice Address - Street 2:SUITE 614
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601
Practice Address - Country:US
Practice Address - Phone:872-267-9167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0710003457103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist