Provider Demographics
NPI:1093589459
Name:STAHLER, JOSEPH DAVID (LSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DAVID
Last Name:STAHLER
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 ROSE LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-1562
Mailing Address - Country:US
Mailing Address - Phone:630-648-9281
Mailing Address - Fax:
Practice Address - Street 1:1 E LAKEWOOD AVE
Practice Address - Street 2:
Practice Address - City:NORTHLAKE
Practice Address - State:IL
Practice Address - Zip Code:60164-2592
Practice Address - Country:US
Practice Address - Phone:708-397-4697
Practice Address - Fax:708-397-4683
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.112099104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker