Healthcare Provider Details
I. General information
NPI: 1427628379
Provider Name (Legal Business Name): STEPHANIE STRIEKER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/01/2021
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date: 07/08/2021
Reactivation Date: 07/22/2021
III. Provider practice location address
333 N RANDALL RD STE 20
ST CHARLES IL
60174-1500
US
IV. Provider business mailing address
333 N RANDALL RD STE 20
ST CHARLES IL
60174-1500
US
V. Phone/Fax
- Phone: 847-507-3583
- Fax:
- Phone: 847-507-3583
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 150116462 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: