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Individual

ELIZABETH MARY STAPLETON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPE

Contact information

Practice address
231 S GARY AVE STE 112, BLOOMINGDALE, IL 60108-2227
(630) 220-7313
Mailing address
1348 COURT LEONA, HANOVER PARK, IL 60133-5419
(630) 750-9931

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
220.000019
IL

Other

Enumeration date
07/11/2021
Last updated
07/11/2021
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