Provider Demographics
NPI:1962023465
Name:DAGIAN-STANTON, CATHERINE THERESA (RN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:THERESA
Last Name:DAGIAN-STANTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 MONARCH LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1178
Mailing Address - Country:US
Mailing Address - Phone:847-431-0064
Mailing Address - Fax:
Practice Address - Street 1:1900 HASSELL RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-6302
Practice Address - Country:US
Practice Address - Phone:847-781-4850
Practice Address - Fax:847-781-4869
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041220171163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse