Individual
DESMOND STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
486 RANDALL RD UNIT B, SOUTH ELGIN, IL 60177-3354
(847) 931-1813
(847) 931-1861
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036.171409
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2020
Last updated
08/19/2024
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