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General NPI Number Information
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NPI Number | 1831665074
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Entity Type | Individual
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Provider Name | STACY PROPP DACM, L.AC
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Gender | Female
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | 1845 S MICHIGAN AVE CHICAGO INHEALTH CENTER
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City | CHICAGO
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State | IL
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Zip | 60616
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Country | US
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Telephone | 312-414-1088
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Fax |
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Provider Business Mailing Address
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Address Line | 2140 W LYNDALE ST
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City | CHICAGO
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State | IL
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Zip | 60647-3345
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Country | US
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Telephone | 773-251-0461
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 198.001424
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License Number State | IL
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