Individual
AVA H STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9831 S WESTERN AVE, CHICAGO, IL 60643-1740
(773) 445-3500
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01034050A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
036-055875
IL
207RC0000X
Cardiovascular Disease Physician
25MA05871900
NJ
Other
Enumeration date
01/29/2007
Last updated
05/04/2022
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