Provider Demographics
NPI:1194023747
Name:ALDER, GRETCHEN STELLMAN
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:STELLMAN
Last Name:ALDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-4503
Mailing Address - Country:US
Mailing Address - Phone:224-201-6485
Mailing Address - Fax:
Practice Address - Street 1:2135 CITY GATE LN STE 300
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3066
Practice Address - Country:US
Practice Address - Phone:630-423-6010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program