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Individual

DR. DOUGLAS M STAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
396 BELLE AIRE AVE, BOURBONNAIS, IL 60914-2010
(815) 933-7391
Mailing address
396 BELLE AIRE AVE, BOURBONNAIS, IL 60914-2010
(815) 933-7391

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004682104
BC/BS NUMBER
IL
Enumeration date
08/19/2006
Last updated
09/06/2023
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