Kenneth Stall's National Provider Identifier (NPI) Details
Kenneth Stall, LCSW
NPI: 1245344837
Enumeration Date: 2006-08-19
Last updated: 2007-07-08
Sole Proprietor: YES
Status: active
Postal Address: 708 FOSTER AVE, LAKE BLUFF, IL
Phone: 847-367-6900
Primary Practice Address: 1117 S MILWAUKEE AVE, LIBERTYVILLE, IL
Practice's phone: 847-367-6900