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General NPI Number Information
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NPI Number | 1497740393
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Entity Type | Individual
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Provider Name | STUART A ISSLEIB MD
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Gender | Male
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 04/19/2018
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Provider Practice Location Address
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Address Line | 5201 WILLOW SPRINGS RD STE 450
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City | LA GRANGE HIGHLANDS
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State | IL
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Zip | 60525-6545
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Country | US
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Telephone | 630-336-7870
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Fax | 312-328-7986
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Provider Business Mailing Address
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Address Line | 720 W NORTH ST
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City | HINSDALE
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State | IL
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Zip | 60521-3044
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Country | US
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Telephone | 630-336-7870
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036074032
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License Number State | IL
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