Individual
LYNN STASENKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
466 BERKSHIRE DR, CRYSTAL LAKE, IL 60014-7400
(815) 823-6619
Mailing address
466 BERKSHIRE DR, CRYSTAL LAKE, IL 60014-7400
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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