Individual
STEPHANIE SKELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
723 STATION XING, WATERLOO, IL 62298-1886
(618) 939-1551
(618) 939-1553
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
(615) 465-7000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-095296
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095296
—
IL
Enumeration date
06/10/2005
Last updated
07/23/2013
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