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NPI Code Detail

MEDICARE: MR. MARK STEVEN STOLSPART FNP-BC

MEDICARE: MR. MARK STEVEN STOLSPART FNP-BC
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
1363LF0000XFamily Nurse Practitioner277.005006IL

General Provider Information

NPI Number : 1437428786
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK STEVEN STOLSPART FNP-BC
Provider Business Mailing Address
First Line : PO BOX 746715
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6715
Country : US
Telephone Number : 773-724-6200
Fax Number : 773-866-8015
Provider Business Practice Location Address
First Line : 4848 W IRVING PARK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2718
Country : US
Telephone Number : 773-724-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2011
Last Update Date : 03/27/2026

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