Individual
STEVEN R STAKENAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CNP
Contact information
Practice address
1331 W 75TH ST STE 101, NAPERVILLE, IL 60540-9311
(630) 646-7000
(305) 481-5636
Mailing address
245 S GARY AVE STE 100, BLOOMINGDALE, IL 60108-2200
(630) 933-4550
(630) 933-2200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209006058
IL
363LF0000X
Family Nurse Practitioner
209-006058
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IL
Enumeration date
10/10/2006
Last updated
08/14/2024
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