Provider Demographics
NPI:1427342393
Name:STIRK, LINDSAY M (DPT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:M
Last Name:STIRK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:
Practice Address - Street 1:4102 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE B
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4183
Practice Address - Country:US
Practice Address - Phone:302-894-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE231043Y0XMedicare PIN