Provider Demographics
NPI:1871791905
Name:STOECKER, ASHLEY DIANE (DO)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DIANE
Last Name:STOECKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:DIANE
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:303 E ARMY TRAIL RD STE 203
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2143
Mailing Address - Country:US
Mailing Address - Phone:630-225-1464
Mailing Address - Fax:630-349-8421
Practice Address - Street 1:303 E ARMY TRAIL RD STE 203
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2143
Practice Address - Country:US
Practice Address - Phone:630-225-1464
Practice Address - Fax:630-349-8421
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036126274207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine