Provider Demographics
NPI:1710607213
Name:STANCZAK, LAURA (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:STANCZAK
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1572 S CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-7524
Mailing Address - Country:US
Mailing Address - Phone:847-476-3301
Mailing Address - Fax:
Practice Address - Street 1:4055 VALLEY VIEW LN STE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5071
Practice Address - Country:US
Practice Address - Phone:847-476-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209025782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily