SearchIllinois314000000X

Anthony Stark, LPTA

NPI 1306119102 · on the registry since 2012 · sole proprietor

Practice

Address
3751 Round Hill Rd
Apt 5
Swansea, IL 62226
Phone
(469) 939-6867

Registry record

Primary taxonomy
314000000X
314000000X
Also registered as
310400000X
225200000X
Licence states on file
IL, TX
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-02-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois