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NPI Code Detail

MEDICARE: STEPHANIE E PEDROZA PA-C

MEDICARE:   STEPHANIE E PEDROZA  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant085006262IL

General Provider Information

NPI Number : 1063936607
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE E PEDROZA PA-C
Provider Business Mailing Address
First Line : 4440 W 95TH ST
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-2600
Country : US
Telephone Number : 708-684-8000
Fax Number :
Provider Business Practice Location Address
First Line : 1220 S WOOD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1202
Country : US
Telephone Number : 312-996-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2017
Last Update Date : 02/16/2026

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Directions to “ STEPHANIE E PEDROZA PA-C” Practice Location

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