Provider Demographics
NPI:1942389325
Name:PINKWATER, STUART (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:PINKWATER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1866 SHERIDAN RD STE 305
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2546
Mailing Address - Country:US
Mailing Address - Phone:847-951-3951
Mailing Address - Fax:
Practice Address - Street 1:1866 SHERIDAN RD
Practice Address - Street 2:SUITE 216
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2547
Practice Address - Country:US
Practice Address - Phone:847-433-0800
Practice Address - Fax:847-432-3862
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004679103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist