Provider Demographics
NPI:1104971514
Name:STOLTZMAN, PATRICIA (APN, CNM, MS)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:STOLTZMAN
Suffix:
Gender:F
Credentials:APN, CNM, MS
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:FORNOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1555 BARRINGTON RD STE 335
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1064
Mailing Address - Country:US
Mailing Address - Phone:847-839-0900
Mailing Address - Fax:
Practice Address - Street 1:1555 BARRINGTON RD STE 335
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1064
Practice Address - Country:US
Practice Address - Phone:847-839-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209002008163WX0002X
IL209-002008367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk