IndividualActive
Nanci Stark, APRN
NPI 1629614136 · Gerontology Clinical Nurse Specialist · La Grange, IL
Provider details
- NPI number
- 1629614136
- Entity type
- Individual
- Primary specialty
- Gerontology Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- License
- 20901978 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
705 S Kensington Ave
La Grange, IL 60525-2708
Phone: (708) 216-8554
Approximate (ZIP-level) locationGet directions
Mailing address
705 S Kensington Ave
La Grange, IL 60525-2708
Registry dates
- Enumerated
- 2019-11-19
- Last updated
- 2019-11-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.