Individual
ELIZABETH ANN STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
400 E HILLCREST DR STE 110, DEKALB, IL 60115-2470
(815) 758-5508
(815) 758-5537
Mailing address
400 E HILLCREST DR STE 110, DEKALB, IL 60115-2470
(815) 758-5508
(815) 758-5537
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.017362
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6240740001
MEDICARE PTAN
IL
Enumeration date
08/31/2009
Last updated
08/20/2012
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