Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036145696 | IL |
Y | 208000000X | Pediatrician | 125067293 | IL |
NPI | 1003296849 |
---|---|
Provider Name | Carly Stokar |
First Address | Chicago, IL 60642-2607 |
Second Address | Skokie, IL 60067 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2015 |
Last Update Date | 10/12/2021 |