Provider Demographics
NPI:1780780429
Name:PITTENGER, STEPHANIE MARIE (DC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:PITTENGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W HIGGINS RD STE 965
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2048
Mailing Address - Country:US
Mailing Address - Phone:847-466-5157
Mailing Address - Fax:847-466-5764
Practice Address - Street 1:2500 W HIGGINS RD STE 965
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2048
Practice Address - Country:US
Practice Address - Phone:847-466-5157
Practice Address - Fax:847-466-5764
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0568-2001OtherBLUE CROSS BLUE SHIELD