Mark M. Stahnke, M.DIV.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

542 Crosat St
La Salle, IL 61301-2226

Phone

(815) 223-4007

Fax

(815) 224-4550

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Catholic Charities of the Diocese of Peoria

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IL
  • NPI 1285693630
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821205154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19183 PLOW CREEK RD UNIT 6",
            "city": "TISKILWA",
            "state": "IL",
            "postal_code": "613689126",
            "telephone_number": "815-646-4851",
            "fax_number": "815-223-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 CROSAT ST",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613012226",
            "telephone_number": "815-223-4007",
            "fax_number": "815-224-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHNKE",
        "first_name": "MARK",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "M.DIV.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Speech Suite 815
• St. Margaret's Health-Peru
• St. Margaret's Health-Peru
• St. Margaret's Health-Peru (IVCH MEDICAL GROUP / LaSalle Medical Clinic)
• St. Margaret's Health-Peru (IVCH MEDICAL GROUP/ LaSalle Medical Clinic)
• Anita Stegall
• Danielle G Stoddard, LCPC
• Amanda Stone
• Douglas Michael Suarez
• Lisa Sweeney, LCSW

• Marriage & Family Therapist in La Salle, IL
• Providers in La Salle, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.