Provider Demographics
NPI:1215240981
Name:DROZD, STEFANIE A (APN)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:A
Last Name:DROZD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:A
Other - Last Name:BLUEMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:2320 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BLUE ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60406-2426
Mailing Address - Country:US
Mailing Address - Phone:708-388-5500
Mailing Address - Fax:708-226-7170
Practice Address - Street 1:2320 HIGH ST
Practice Address - Street 2:
Practice Address - City:BLUE ISLAND
Practice Address - State:IL
Practice Address - Zip Code:60406-2426
Practice Address - Country:US
Practice Address - Phone:708-388-5500
Practice Address - Fax:708-226-7174
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008231363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL964290011Medicare PIN
ILIL3596001Medicare PIN