Mestemaker, Tonya Marie

Mestemaker, Tonya Marie is an sole proprietor health care provider with primary practice located at 900 N Shore Dr Suite 174, Lake Bluff IL 60044-2243. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mestemaker, Tonya Marie can be contacted via phone (773) 383-7700.

Contact Information

Primary practice address
900 N Shore Dr Suite 174 Lake Bluff IL 60044-2243
Fax: (847) 615-1697
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Illinois

Profile Details

NPI number 1659460715
LBN Legal business name Mestemaker, Tonya Marie
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659460715 NPPES
Illinois Other 04932470 BCBS PROVIDER NUMBER

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