Healthcare Provider Details

I. General information

NPI: 1235635269
Provider Name (Legal Business Name): MEGAN STEFANI APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN KOLKAY

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 OGDEN AVE STE 401
AURORA IL
60504-7208
US

IV. Provider business mailing address

2040 OGDEN AVE STE 401
AURORA IL
60504-7208
US

V. Phone/Fax

Practice location:
  • Phone: 630-499-6688
  • Fax:
Mailing address:
  • Phone: 630-499-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209017406
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: