Provider Demographics
NPI:1336776558
Name:STELLA, CHRISTINE (DO)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:STELLA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17333 LA GRANGE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487-7510
Mailing Address - Country:US
Mailing Address - Phone:708-226-2440
Mailing Address - Fax:708-923-5364
Practice Address - Street 1:17333 LA GRANGE RD STE 100
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-7510
Practice Address - Country:US
Practice Address - Phone:708-226-2440
Practice Address - Fax:708-923-5364
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125076453207R00000X
390200000X
IL036.164458207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program