Individual
STEPHEN BANCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5140 N CALIFORNIA AVE, CHICAGO, IL 60625-3645
(630) 470-7483
Mailing address
5140 N CALIFORNIA AVE, CHICAGO, IL 60625-3645
(773) 989-3957
(773) 989-3971
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085009321
IL
Other
Enumeration date
10/18/2022
Last updated
01/03/2023
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