Provider Demographics
NPI:1588055958
Name:STETA, MARIE (APN)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:STETA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 N MILL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2261
Mailing Address - Country:US
Mailing Address - Phone:630-646-8000
Mailing Address - Fax:630-646-8007
Practice Address - Street 1:1335 N MILL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2261
Practice Address - Country:US
Practice Address - Phone:630-646-8000
Practice Address - Fax:630-646-8007
Is Sole Proprietor?:No
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.012496363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology