Individual
DR. STACEY KATHLEEN STURGULEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
5000 S 5TH AVE, AUDIOLOGY AND SPEECH - 126, HINES, IL 60141-3030
(708) 202-8387
(708) 202-5260
Mailing address
3044 N 78TH CT, ELMWOOD PARK, IL 60707-1018
(312) 259-8378
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147001169
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147-001169
STATE LICENSE
IL
Enumeration date
01/30/2007
Last updated
02/27/2012
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