Individual
MARY CAITLIN STASAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3134 N CLARK ST, CHICAGO, IL 60657-4414
(773) 880-9722
(773) 880-9723
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041428319
IL
363L00000X
Nurse Practitioner
Primary
209.028934
IL
Other
Enumeration date
02/25/2022
Last updated
04/09/2024
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