Stefanie C Kadolph, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

085001792 Issued in IL

Practice address

1100 W Central Rd
Suite 200
Arlington Heights, IL 60005-2402

Phone

(847) 392-5440

Fax

(847) 392-8439

NPI assigned

Sep 20, 2005

Last updated

May 30, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arlington Dermatology SC

  • Dermatology Physician
  • Rolling Meadows, IL
  • NPI 1689692386
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1114913654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W CENTRAL RD",
            "address_2": "SUITE 200",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052402",
            "telephone_number": "847-392-5440",
            "fax_number": "847-392-8439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W CENTRAL RD",
            "address_2": "SUITE 200",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052402",
            "telephone_number": "847-392-5440",
            "fax_number": "847-392-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADOLPH",
        "first_name": "STEFANIE",
        "middle_name": "C",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085001792",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085001792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jura Adams, M.D., LTD.
• Logan Just, MOT, OTR/L
• Maggie Jutla, RN
• K J Kohan DDS LTD
• Katherine Kaderabek, RBT
• Kristie Lynn Kady, RN, IBCLC
• Diane Kaffka
• Randall C. Kahan, M.D.
• Sydney Michelle Kahl, PA-C
• Debora Marie Kahn

• Surgical Physician Assistant in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.