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NPI Code Detail

MEDICARE: SYDNEY STATHES PMHNP-BC

MEDICARE: SYDNEY STATHES PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerRN2313945MA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner277003150IL

General Provider Information

NPI Number : 1225677354
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY STATHES PMHNP-BC
Provider Business Mailing Address
First Line : 213 W INSTITUTE PL STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60610-8792
Country : US
Telephone Number : 312-471-2250
Fax Number : 267-367-5929
Provider Business Practice Location Address
First Line : 213 W INSTITUTE PL STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60610-8792
Country : US
Telephone Number : 312-471-2250
Fax Number : 267-367-5929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2020
Last Update Date : 12/30/2025

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Directions to “ SYDNEY STATHES PMHNP-BC” Practice Location

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