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Individual

STEPHANIE ANGELA FAZLIBASIC

Active
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Individual

STEPHANIE ANGELA FAZLIBASIC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
209.017770
IL
363LF0000X
Family Nurse Practitioner
Primary
277002965
IL

Other

Enumeration date
08/29/2018
Last updated
06/12/2024
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