Provider Demographics
NPI:1861070203
Name:STAMMEN, MARCUS (DO)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:STAMMEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 PERSIMMON DR
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1326
Mailing Address - Country:US
Mailing Address - Phone:630-479-5330
Mailing Address - Fax:
Practice Address - Street 1:2530 HAUSER ROSS DR STE 100
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3147
Practice Address - Country:US
Practice Address - Phone:815-766-9903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151015775207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology