Individual
STEPHANIE LARIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2490 BUSHWOOD DR, ELGIN, IL 60124-7898
(224) 293-5200
Mailing address
3211 W BELLE PLAINE AVE APT 2A, CHICAGO, IL 60618-2326
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006297
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/01/2017
Last updated
03/07/2019
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