Provider Demographics
NPI:1679951412
Name:STEGMAIER, JO ANN ROBERTA (APN,NPC)
Entity type:Individual
Prefix:
First Name:JO ANN
Middle Name:ROBERTA
Last Name:STEGMAIER
Suffix:
Gender:F
Credentials:APN,NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13246 STRATFORD LN
Mailing Address - Street 2:13246 STRATFORD
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-7710
Mailing Address - Country:US
Mailing Address - Phone:224-569-3706
Mailing Address - Fax:
Practice Address - Street 1:13246 STRATFORD LN
Practice Address - Street 2:13246 STRATFORD
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-7710
Practice Address - Country:US
Practice Address - Phone:224-569-3706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209002987363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care