Healthcare Provider Details

I. General information

NPI: 1164383535
Provider Name (Legal Business Name): STEPHANIE O'NEILL APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30W160 OXFORD DR
WARRENVILLE IL
60555-1014
US

IV. Provider business mailing address

30W160 OXFORD DR
WARRENVILLE IL
60555-1014
US

V. Phone/Fax

Practice location:
  • Phone: 630-281-0629
  • Fax:
Mailing address:
  • Phone: 630-281-0629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209.034188
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: