Healthcare Provider Details

I. General information

NPI: 1477324655
Provider Name (Legal Business Name): GABRIELA STOIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 N SHERIDAN RD
CHICAGO IL
60640-1601
US

IV. Provider business mailing address

28412 N HILLTOP TER
MUNDELEIN IL
60060-9556
US

V. Phone/Fax

Practice location:
  • Phone: 773-944-0484
  • Fax:
Mailing address:
  • Phone: 714-220-7958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209029184
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036-099795
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: