Individual
LEIA STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3021 FALLING WATERS BLVD, STE B, LINDENHURST, IL 60046-6745
(847) 356-2895
Mailing address
3021 FALLING WATERS BLVD, STE B, LINDENHURST, IL 60046-6745
(847) 356-2895
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
227011885
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227011885
STATE OF ILLINOIS
IL
Enumeration date
02/03/2012
Last updated
02/03/2012
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