Provider Demographics
NPI:1104811223
Name:STERN, DARRYL A (MD)
Entity type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:A
Last Name:STERN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9669 KENTON AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1266
Mailing Address - Country:US
Mailing Address - Phone:847-677-0212
Mailing Address - Fax:847-677-0231
Practice Address - Street 1:9669 KENTON AVE
Practice Address - Street 2:STE 203
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1266
Practice Address - Country:US
Practice Address - Phone:847-677-0212
Practice Address - Fax:847-677-0231
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2021-12-15
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Provider Licenses
StateLicense IDTaxonomies
IL036103953207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH40436Medicare UPIN