Individual
ROGER STUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
676 N SAINT CLAIR ST, SUITE 2210, CHICAGO, IL 60611-2927
(312) 926-1094
Mailing address
676 N SAINT CLAIR ST, SUITE 2210, CHICAGO, IL 60611-2927
(312) 926-1094
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036141727
IL
2084N0400X
Neurology Physician
036141727
IL
Other
Enumeration date
01/17/2017
Last updated
11/08/2021
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