Provider Demographics
NPI:1417483348
Name:ORR, STEPHANIE DENISE (APN)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:DENISE
Last Name:ORR
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 1:5115 S UNIVERSITY AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-3961
Mailing Address - Country:US
Mailing Address - Phone:312-420-9624
Mailing Address - Fax:
Practice Address - Street 1:5115 S UNIVERSITY AVE APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-3961
Practice Address - Country:US
Practice Address - Phone:312-420-9624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.015949363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care