Provider Demographics
NPI:1477749562
Name:STOLIN, MICHELLE TERESE (MPT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:TERESE
Last Name:STOLIN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:TERESE
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:
Practice Address - Street 1:951 WATERBURY FALLS DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368
Practice Address - Country:US
Practice Address - Phone:636-336-0300
Practice Address - Fax:636-336-0297
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006039083225100000X
CO9775225100000X
CAPT293871225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist