Basic Information
| Provider Information | |||||||||
| NPI: | 1003296849 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STOKAR | ||||||||
| FirstName: | CARLY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1460 N HALSTED ST STE 402 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606422607 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3722 W TOUHY AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3122272860 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2015 | ||||||||
| LastUpdateDate: | 12/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 036145696 | IL | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 125067293 | IL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.