Provider Demographics
NPI:1922097328
Name:ROMER, STEPHANIE ANN (ADVANCED PRACTICE NU)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ANN
Last Name:ROMER
Suffix:
Gender:F
Credentials:ADVANCED PRACTICE NU
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:ZIMMERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OFFICE MANAGER
Mailing Address - Street 1:27750 W HIGHWAY 22
Mailing Address - Street 2:STE 120
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2379
Mailing Address - Country:US
Mailing Address - Phone:847-277-0500
Mailing Address - Fax:847-277-0505
Practice Address - Street 1:27750 W HIGHWAY 22
Practice Address - Street 2:STE 120
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2379
Practice Address - Country:US
Practice Address - Phone:847-277-0500
Practice Address - Fax:847-277-0505
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209003157363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04923240OtherBCBS
IL04923240OtherBCBS
566870Medicare ID - Type Unspecified