Most Relevant Information
Provider Data
| NPI Number: | 1003664830 |
| Provider Name: | STEPHEN BALDASSARI |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/07/2024 |
| Last Updated: | 05/07/2024 |
Provider Practice Location
600 S PAULINA ST STE 403
CHICAGO
IL
606123806
Practice Location Phone/Fax
| Phone: | 3129427100 |
| Fax: |
Provider Mailing Location
600 S PAULINA ST STE 403
CHICAGO
IL
606123806
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |