Individual
LISA STANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4300 MBL DR, OTTAWA, IL 61350-9356
(815) 431-3848
(414) 622-3872
Mailing address
4300 MBL DR, OTTAWA, IL 61350-9356
(815) 431-3848
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.438251
IL
363LA2100X
Acute Care Nurse Practitioner
209030199
IL
363LF0000X
Family Nurse Practitioner
Primary
209030199
IL
Other
Enumeration date
07/01/2022
Last updated
10/11/2024
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