Provider Demographics
NPI:1942473947
Name:ALI, STEFANIE A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:A
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:STEFANIE
Other - Middle Name:A
Other - Last Name:HIRANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1600 N RANDALL RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123
Mailing Address - Country:US
Mailing Address - Phone:847-381-8899
Mailing Address - Fax:
Practice Address - Street 1:1600 N RANDALL RD
Practice Address - Street 2:SUITE 400
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123
Practice Address - Country:US
Practice Address - Phone:815-744-8554
Practice Address - Fax:815-744-3969
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.137740207N00000X
IN01073875A207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology