MEDICARE: SYDNEY STEFANIK LMT

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
1	225700000X	Massage Therapist	227023776	IL

General Provider Information

NPI Number	:	1578378394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY STEFANIK LMT

Provider Business Mailing Address
First Line	:	720 N PINE AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-5630
Country	:	US
Telephone Number	:	847-915-2679
Fax Number	:

Provider Business Practice Location Address
First Line	:	1770 1ST ST STE 400
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-3237
Country	:	US
Telephone Number	:	312-321-0004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	02/10/2025

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