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General NPI Number Information
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NPI Number | 1336209329
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Entity Type | Organization
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Legal Business Name | KRISTIN STAHL MD PC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 101 UNITED DR SUITE 110
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City | COLLINSVILLE
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State | IL
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Zip | 62234-7428
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Country | US
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Telephone | 618-855-9041
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Fax | 618-855-9046
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Provider Business Mailing Address
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Address Line | 101 UNITED DR SUITE 110
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City | COLLINSVILLE
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State | IL
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Zip | 62234-7428
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Country | US
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Telephone | 618-855-9041
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Fax | 618-855-9046
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. KRISTIN E STAHL
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Credential |
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Telephone | 314-833-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 036100294
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License Number State | IL
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