Provider Demographics
NPI:1730566761
Name:YINGLING, STEPHANIE (MOT,OTR/L)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:YINGLING
Suffix:
Gender:F
Credentials:MOT,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:62353-1208
Mailing Address - Country:US
Mailing Address - Phone:217-242-7037
Mailing Address - Fax:
Practice Address - Street 1:435 CAMDEN RD
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:IL
Practice Address - Zip Code:62353-1058
Practice Address - Country:US
Practice Address - Phone:217-773-3377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.010903225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist