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General NPI Number Information
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NPI Number | 1841624491
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Entity Type | Individual
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Provider Name | CHERYL STONE
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Gender | Female
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 4440 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2600
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Country | US
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Telephone | 708-684-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2528 HARVEST DR
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City | CROWN POINT
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State | IN
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Zip | 46307-9683
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Country | US
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Telephone | 219-677-6039
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number | 238.000370
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 238.000370
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License Number State | IL
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