Individual
KEVIN STALSBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 HART RD, SUITE 115, BARRINGTON, IL 60010-2623
(847) 277-7444
Mailing address
12400 S HARLEM AVE, PALOS HEIGHTS, IL 60463-1440
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01622333
BLUE CROSS BLUE SHIELD
IL
01
—
7454077
AETNA
IL
Enumeration date
11/23/2007
Last updated
11/23/2007
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