Raymond Jerome Stadt ATC

NPI 1164435657 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1164435657
Gender Male
Enumeration Date 08/14/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
12700 SACRAMENTO AVE
BLUE ISLAND IL, 60406-1822, US
Phone (708) 597-6300
Fax (708) 597-6386
Business Location
20032 S MALLORY DR
FRANKFORT IL, 60423-9279, US
Phone (630) 806-8347
Fax
Toxanomy
Taxonomy Code 2255A2300X
License State
License Number
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According to our database, Raymond Jerome Stadt ATC NPI is 1164435657, taxonomy code is 2255A2300X Raymond Jerome Stadt ATC physically located at 12700 Sacramento Ave, Blue Island IL, 60406-1822. NPI Number Raymond Jerome Stadt ATC has the Individual type.

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1164435657 NPI number is provided on an as is basis without warranty of any kind. 1164435657 is maintained by the National Plan & Provider Enumeration System. The contents of Raymond Jerome Stadt ATC are for informational purposes only.