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General NPI Number Information
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NPI Number | 1033971932
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Entity Type | Individual
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Provider Name | STEPHANIE JANE ABILA CHANITTHIKUL
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Gender | Female
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 1901 N ROSELLE RD STE 800
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City | SCHAUMBURG
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State | IL
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Zip | 60195-3186
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Country | US
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Telephone | 443-383-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 395 LAFAYETTE LN
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-4132
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Country | US
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Telephone | 847-721-7562
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070024100
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License Number State | IL
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