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Individual
DR. STEFANIE LORRAINE WILDE
Active
Individual
DR. STEFANIE LORRAINE WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038008963
IL
111N00000X
Chiropractor
3921
OH
111N00000X
Chiropractor
Primary
CH10052
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038008963
—
IL
01
—
10132196
BCBS
IL
Enumeration date
07/03/2006
Last updated
07/19/2022
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