MS. STACEY K ROLINE (NPI# 1003187469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003187469 |
| Entity Type | Individual |
| Full Name | MS. STACEY K ROLINE |
| Credential | PA-C |
| Practice Address |
1775 Dempster St Park Ridge IL 60068-1143 |
| Practice Telephone | 8477232210 |
| Practice Fax Number | 8476927915 |
| Mailing Telephone | 8477232210 |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2012-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
085.004160 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1775 DEMPSTER ST |
| City | PARK RIDGE |
| State | IL |
| Zip Code | 60068-1143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386642452 | Asya S. Ali | Pathology | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2005-07-12 |
| 1245847656 | Susie Annette Gonzalez | Nurse Practitioner | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-29 |
| 1598370231 | Maria Staed Dwyer | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-10 |
| 1851906598 | Izabela Koszczuk | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-10 |
| 1760097406 | Mark Andrew Fasick | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-10 |
| 1962014183 | Eric Swanson | Nurse Anesthetist, Certified Registered | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-08-19 |
| 1740804046 | Lauren Kay | Nurse Practitioner | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-06-02 |
| 1326660234 | Kellyn Bailey | Occupational Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-05-13 |
| 1659992964 | Emma Hogaboom | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-04-28 |
| 1003436403 | Sandra Kroschel | Nurse's Aide | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861010720 | Caitlin Marie Kompanowski | Dentist | 412 W. Talcott, Park Ridge, IL 60068 | 2020-07-08 |
| 1972142198 | Center for Authentic Living, Inc. | Counselor | 120 Main Street Suite 200, Park Ridge, IL 60068 | 2020-01-06 |
| 1306312152 | Maryann Almores Devilla | Physical Medicine & Rehabilitation | Sunrise Assisted Living, 1725 Ballard Road, Park Ridge, IL 60068 | 2018-10-19 |
| 1053808857 | Landon Ginsberg | Student in an Organized Health Care Education/Training Program | 1775 Ballard, Park Ridge, IL 60068 | 2018-04-17 |
| 1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
| 1205367448 | Courtney Heim | Psychiatry & Neurology | 1875 W.dempster Street - Park Side Professional Center, Ste 470, Park Ridge, IL 60068 | 2017-03-21 |
| 1720521362 | Alexander Mylonas | Psychologist | 1400 Renaissance Dr Ste 401, Park Ridge, IL 60068 | 2016-11-30 |
| 1376090878 | Rebecca Rajasekhar | Audiologist | 1030 W. Higgins Rd., Audiology Room 6, Park Ridge, IL 60068 | 2016-09-01 |
| 1164818449 | Mohammad Taha Mustaf Taha Mustafa Sheikh | Student in an Organized Health Care Education/Training Program | 1550 North Northwest Highway Suite 107, L.m. Prasad, Md, Sc, Park Ridge, IL 60068 | 2015-04-13 |
| 1518397918 | Megan Roberts | Speech-Language Pathologist | 2240 Campus Dr., Evanston, IL 60068 | 2013-11-21 |
| Find all providers in zip 60068 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821140583 | James L Ballard | Physician Assistant | 1231 Brophy Avenue, Park Ridge, IL 60068-5225 | 2007-01-16 |
| 1114572872 | Angela Catherine Sherman | Physician Assistant | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2019-08-08 |
| 1487147393 | Kristen Reed | Physician Assistant | 1875 Dempster St Ste 265, Park Ridge, IL 60068-1126 | 2018-06-14 |
| 1518226356 | Timothy P Wombacher | Physician Assistant | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2012-05-14 |
| 1982980629 | Natalia M Waz | Physician Assistant | 1775 Dempster St, Park Ridge, IL 60068-1174 | 2011-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169522 | Priority Assist Pllc | Physician Assistant | 48 Glenda Ln, Plano, IL 60545-9652 | 2020-09-23 |
| 1154944478 | Diana Goldak | Physician Assistant | 3855 N Parkway Dr Apt 3a, Northbrook, IL 60062-7218 | 2020-05-20 |
| 1033742580 | Colleen Courtney | Physician Assistant | 218 S Driftwood Trl, Mchenry, IL 60050-5454 | 2020-02-12 |
| 1326678962 | Nina Kodros | Physician Assistant | 301 Madison St Ste 280, Joliet, IL 60435-6672 | 2020-01-23 |
| 1689218190 | Jennifer Richman | Physician Assistant | 1890 Silver Cross Blvd Ste 410, New Lenox, IL 60451-9547 | 2019-10-29 |
| 1710547625 | Nadia Khan | Physician Assistant | 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 | 2019-06-13 |
| 1962065516 | Jorge Mantilla | Physician Assistant | 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 | 2019-04-18 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1770041949 | Laura Ann Ryan | Physician Assistant | 840 S Wood St Ste 417, Chicago, IL 60612-4325 | 2019-03-06 |
| 1548739782 | Helen Finke | Physician Assistant | 880 W Central Rd Ste 3300, Arlington Heights, IL 60005-2366 | 2018-11-16 |
| Find all providers with the same taxonomy | ||||
| City | PARK RIDGE |
| Zip Code | 60068 |
Please comment or provide details below to improve the information on MS. STACEY K ROLINE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.