Provider Demographics
NPI:1457175044
Name:STEVANOVSKI, PAULEANA LOUISE (PA-C)
Entity type:Individual
Prefix:
First Name:PAULEANA
Middle Name:LOUISE
Last Name:STEVANOVSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W WRIGHTWOOD AVE APT 716
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1782
Mailing Address - Country:US
Mailing Address - Phone:248-860-9005
Mailing Address - Fax:
Practice Address - Street 1:1S443 SUMMIT AVE STE 201
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3972
Practice Address - Country:US
Practice Address - Phone:630-250-3862
Practice Address - Fax:630-613-9865
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant