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General NPI Number Information
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NPI Number | 1588666093
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Entity Type | Individual
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Provider Name | ROSEMARIE STEFANIW-GOTTLIEB PMHNP-BC, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 100 N ATKINSON RD STE 106
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City | GRAYSLAKE
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State | IL
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Zip | 60030-7805
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Country | US
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Telephone | 888-211-8171
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Fax | 847-316-9797
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Provider Business Mailing Address
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Address Line | 1710 WALNUT CT
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City | SPRING GROVE
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State | IL
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Zip | 60081-8074
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Country | US
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Telephone | 847-899-9399
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277.003947
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 277.003947
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License Number State | IL
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