Healthcare Provider Details

I. General information

NPI: 1902894710
Provider Name (Legal Business Name): DEAN S STERN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S MAPLE AVE STE 2550
OAK PARK IL
60304-2807
US

IV. Provider business mailing address

1660 FEEHANVILLE DR STE 450
MOUNT PROSPECT IL
60056-6023
US

V. Phone/Fax

Practice location:
  • Phone: 708-660-6100
  • Fax: 708-660-0447
Mailing address:
  • Phone: 847-390-7666
  • Fax: 847-390-9345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number016002903
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016002903
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: