Provider Demographics
NPI:1821231234
Name:MARTHA S. STAMPER, PSY.D. P.C.
Entity type:Organization
Organization Name:MARTHA S. STAMPER, PSY.D. P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:STAMPER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-519-0520
Mailing Address - Street 1:1340 REMINGTON RD.
Mailing Address - Street 2:STE T
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4821
Mailing Address - Country:US
Mailing Address - Phone:847-519-0520
Mailing Address - Fax:847-519-0522
Practice Address - Street 1:1340 REMINGTON RD.
Practice Address - Street 2:STE T
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4821
Practice Address - Country:US
Practice Address - Phone:847-519-0520
Practice Address - Fax:847-519-0522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-006262103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty