Provider Demographics
NPI:1194331827
Name:STEALEY, REBECCA (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STEALEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11S250 S JACKSON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-6884
Mailing Address - Country:US
Mailing Address - Phone:630-321-9010
Mailing Address - Fax:630-321-9018
Practice Address - Street 1:11S250 S JACKSON ST STE 101
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-6884
Practice Address - Country:US
Practice Address - Phone:630-321-9010
Practice Address - Fax:630-321-9018
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL041418727163WX0200X
IL309019076363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163WX0200XNursing Service ProvidersRegistered NurseOncologyGroup - Multi-Specialty