Individual
MR. CHRISTOPHER R STADNICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(773) 869-7488
(773) 869-3578
Mailing address
14563 CLUB CIRCLE DR, OAK FOREST, IL 60452-1043
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-001626
IL
363AM0700X
Medical Physician Assistant
085-001626
IL
Other
Enumeration date
04/04/2007
Last updated
04/30/2021
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