Provider Demographics
NPI:1689877136
Name:STANCU, MIHAELA MONICA (MD)
Entity Type:Individual
Prefix:
First Name:MIHAELA
Middle Name:MONICA
Last Name:STANCU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 EASTLAND DR STE 330
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-3534
Mailing Address - Country:US
Mailing Address - Phone:309-663-9800
Mailing Address - Fax:309-664-1761
Practice Address - Street 1:1505 EASTLAND DR
Practice Address - Street 2:SUITE 330
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-3534
Practice Address - Country:US
Practice Address - Phone:309-663-9800
Practice Address - Fax:309-664-1761
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125047297207R00000X
IL036-118185207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine