Individual
MRS. JACLYN LEIGH STAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
101 WAUKEGAN RD STE 1100, LAKE BLUFF, IL 60044-3012
(847) 247-2402
(847) 247-2405
Mailing address
900 RAND RD STE 300, DES PLAINES, IL 60016-2359
(847) 324-3976
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005959
IL
Other
Enumeration date
06/09/2015
Last updated
01/11/2018
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