| Stepping Stones Of Rockford, Inc | |
|
706 N Main St Rockford IL 61103-6904 | |
| (815) 963-0683 | |
| (815) 963-6018 |
| Full Name | Stepping Stones Of Rockford, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 706 N Main St, Rockford, Illinois |
| Authorized Official Name and Position | Candice O'brien (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 8159630683 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stepping Stones Of Rockford, Inc 706 N Main St Rockford IL 61103-6904 Ph: (815) 963-0683 | Stepping Stones Of Rockford, Inc 706 N Main St Rockford IL 61103-6904 Ph: (815) 963-0683 |
| NPI Number | 1437127131 |
|---|---|
| Provider Enumeration Date | 03/09/2006 |
| Last Update Date | 06/25/2024 |
| Certification Date | 06/25/2024 |
| Medicare PECOS PAC ID | 9739283748 |
|---|---|
| Medicare Enrollment ID | O20071228000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437127131 | NPI | - | NPPES |
| Provider Name | Layne Stambaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487016010 PECOS PAC ID: 9830486596 Enrollment ID: I20160922002685 |
| Provider Name | Adriana B De Julio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942509583 PECOS PAC ID: 4183928989 Enrollment ID: I20161025000177 |
| Provider Name | Tript Bajwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457992521 PECOS PAC ID: 0446686943 Enrollment ID: I20200131000941 |
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