Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Elliot Stark, PSYD

Individual provider Clinical Psychologist · NPI 1730607771

Ethan Elliot Stark, PSYD is a Clinical Psychologist in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2017
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

3580 W Medill Ave Apt 2
Chicago, IL 60647-2440
Phone: (608) 335-6705
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 071.010910 (IL)

Record details

NPI number1730607771
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorYes
NPI enumeratedAugust 30, 2017
Last updated in NPPESJune 8, 2023
Certification dateJune 8, 2023

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