Individual
LUKE ELLIOT STANCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 828-2530
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10003098A
IN
363A00000X
Physician Assistant
Primary
5328
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100258538
—
WI
Enumeration date
08/21/2020
Last updated
01/25/2024
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