Provider Demographics
NPI:1093008427
Name:JOHN E. STOPKA M.D. S.C.
Entity Type:Organization
Organization Name:JOHN E. STOPKA M.D. S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOPKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-586-4700
Mailing Address - Street 1:6918 W ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2337
Mailing Address - Country:US
Mailing Address - Phone:773-586-4700
Mailing Address - Fax:773-586-4711
Practice Address - Street 1:6918 W ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2337
Practice Address - Country:US
Practice Address - Phone:773-586-4700
Practice Address - Fax:773-586-4711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty