Individual
MARY IRENE STOWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
14044 W PETRONELLA DR STE 3, LIBERTYVILLE, IL 60048-9656
(847) 549-6044
(847) 549-6058
Mailing address
14044 W PETRONELLA DR STE 3, LIBERTYVILLE, IL 60048-9656
(847) 549-6044
(847) 549-6058
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209002150
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174664882
PROACTIVE ALTERNATIVES PC
IL
Enumeration date
12/28/2006
Last updated
07/11/2019
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