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General NPI Number Information
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NPI Number | 1093589459
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Entity Type | Individual
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Provider Name | JOSEPH DAVID STAHLER LSW
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Gender | Male
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Dates
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Enumeration Date | 11/07/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 1 E LAKEWOOD AVE
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City | NORTHLAKE
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State | IL
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Zip | 60164-2592
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Country | US
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Telephone | 708-397-4697
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Fax | 708-397-4683
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Provider Business Mailing Address
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Address Line | 505 ROSE LN
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City | BARTLETT
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State | IL
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Zip | 60103-1562
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Country | US
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Telephone | 630-648-9281
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.112099
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License Number State | IL
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