Individual
DR. CHRISTOPHER Q STEPHAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7447 W TALCOTT AVE, STE 182, CHICAGO, IL 60631-3712
(773) 792-5155
(773) 594-7975
Mailing address
7447 W TALCOTT AVE, STE 182, CHICAGO, IL 60631-3712
(773) 792-5155
(773) 594-7975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036117889
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
400280
GROUP PTAN
IL
01
—
821050
GROUP PTAN
IL
Enumeration date
07/12/2007
Last updated
12/18/2019
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