Individual
STACEY MARIE SCHULTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
907 N ELM ST STE 300, HINSDALE, IL 60521-3645
(888) 927-2203
Mailing address
280 BUTTE VIEW DR, BOLINGBROOK, IL 60490-1519
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
277.001275
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277.001275
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400127347
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
11/18/2013
Last updated
09/20/2022
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