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Organization

STILLWATER HEALTH PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROLLE DERRADJI PMHNP-BC (OWNER)
(708) 280-6164
Entity
Organization

Contact information

Practice address
3256 W POTOMAC AVE, CHICAGO, IL 60651-2411
(708) 280-6164
Mailing address
3256 W POTOMAC AVE, CHICAGO, IL 60651-2411
(708) 280-6164

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
251S00000X
Community/Behavioral Health Agency
Primary
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
03/14/2026
Last updated
05/12/2026
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