Provider Demographics
NPI:1619369659
Name:RANSOM, STEPHANIE CALABRESE (ATC, OTC, SA-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CALABRESE
Last Name:RANSOM
Suffix:
Gender:F
Credentials:ATC, OTC, SA-C
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MARIE
Other - Last Name:CALABRESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:2115 PERIWINKLE LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-9221
Mailing Address - Country:US
Mailing Address - Phone:847-715-8815
Mailing Address - Fax:
Practice Address - Street 1:550 W OGDEN AVE STE 100
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521
Practice Address - Country:US
Practice Address - Phone:630-323-6116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0960033532255A2300X
IL0127115053246ZX2200X
IL238000602246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant