Organization
CARROLL & JO DAVIES & STEPHENSON ROE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE STIEFEL (REGIONAL SUPERINTENDENT)
(815) 947-3810
Entity
Organization
Contact information
Practice address
500 N RUSH ST, STOCKTON, IL 61085-1004
(815) 947-3810
(815) 947-2717
Mailing address
500 N. RUSH ST., STOCKTON, IL 61085-1004
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/05/2008
Last updated
07/02/2008
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