Goede, Stephanie H

Goede, Stephanie H is an individual health care provider with primary practice located at 420 N Il Route 31 , Crystal Lake IL 60012. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Goede, Stephanie H can be contacted via phone (815) 356-5200.

Contact Information

Primary practice address
420 N Il Route 31 Crystal Lake IL 60012
Fax: (815) 356-5262
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085.004468 Illinois

Profile Details

NPI number 1548519986
LBN Legal business name Goede, Stephanie H
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2012
Last updated Jun 7th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548519986 NPPES
Illinois Other 1108763 NCCPA
Illinois Other 085004468 NCCPA

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