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Organization
ALICIA STOVELL, M.D. PC
Active
Organization
ALICIA STOVELL, M.D. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALICA ANN STOVELL MD, PC (OWNER)
(773) 994-9440
Entity
Organization
Contact information
Practice address
8741 S GREENWOOD AVE STE 101, CHICAGO, IL 60619-7058
(773) 731-8460
(773) 731-8461
Mailing address
8741 S GREENWOOD AVE STE 101, CHICAGO, IL 60619-7058
(773) 731-8460
(773) 731-8461
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
036-082065
IL
Other
Enumeration date
07/31/2007
Last updated
09/10/2008
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