1922036441 NPI number — DR. SANDRA MADRID VALINO STOCK D.O.

Table of content: DR. SANDRA MADRID VALINO STOCK D.O. (NPI 1922036441)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922036441 NPI number — DR. SANDRA MADRID VALINO STOCK D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VALINO STOCK
Provider First Name:
SANDRA
Provider Middle Name:
MADRID
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DOYLE
Provider Other First Name:
SANDRA
Provider Other Middle Name:
VALINO
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922036441
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1701 E WOODFIELD RD STE 215
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCHAUMBURG
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60173-5127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-916-0673
Provider Business Mailing Address Fax Number:
847-787-9084

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1701 E WOODFIELD RD STE 215
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHAUMBURG
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60173-5127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-916-0673
Provider Business Practice Location Address Fax Number:
847-787-9084
Provider Enumeration Date:
06/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  036-116117 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)