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General NPI Number Information
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NPI Number | 1568485464
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Entity Type | Individual
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Provider Name | STACY LYNN ARENS PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1901 W HARRISON ST JOHN H. STROGER HOSPITAL/THE CORE CENTER
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City | CHICAGO
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State | IL
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Zip | 60612-3714
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Country | US
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Telephone | 312-572-4675
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Fax | 312-572-4659
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Provider Business Mailing Address
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Address Line | 3623 N PINE GROVE AVE APT 3E
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City | CHICAGO
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State | IL
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Zip | 60613-5327
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Country | US
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Telephone | 773-301-6675
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Fax | 312-572-4659
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | IL
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