Provider Demographics
NPI:1740572247
Name:STACHNIK, CATHERINE MAYA (DO)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MAYA
Last Name:STACHNIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:KOWALCZYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 SPALDING DR STE 101
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6599
Mailing Address - Country:US
Mailing Address - Phone:630-527-7730
Mailing Address - Fax:
Practice Address - Street 1:120 SPALDING DR STE 101
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6599
Practice Address - Country:US
Practice Address - Phone:630-527-7730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.0596922084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology