Provider Demographics
NPI:1215381306
Name:ALGOZINO, STACEY (APN, CNP)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:ALGOZINO
Suffix:
Gender:F
Credentials:APN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WINFIELD RD FL 3
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1379
Mailing Address - Country:US
Mailing Address - Phone:630-933-2113
Mailing Address - Fax:630-933-4520
Practice Address - Street 1:25 N WINFIELD RD FL 3
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1379
Practice Address - Country:US
Practice Address - Phone:630-933-2113
Practice Address - Fax:630-933-4520
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013817363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily