MEDICARE: STACY ERVIN APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209011244	IL

General Provider Information

NPI Number	:	1003231689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY ERVIN APN

Provider Business Mailing Address
First Line	:	161 WASHINGTON ST FL 14
Second Line	:	EIGHT TOWER BRIDGE, SUITE 1400
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2083
Country	:	US
Telephone Number	:	866-825-3227
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 N MICHIGAN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4255
Country	:	US
Telephone Number	:	866-825-3227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2014
Last Update Date	:	02/19/2014

Similar Medicare Providers

1801871926 — YASMEEN BHATTI MD
Practice Location Address:

401 N MICHIGAN AVE , SUITE 1200
CHICAGO, IL
60611-4255

Practice Phone: 312-635-0973
Practice Fax:

1265406300 — STEVE GNATZ MD
Practice Location Address:

401 N MICHIGAN AVE , SUITE 1200
CHICAGO, IL
60611-4255

Practice Phone: 630-917-4246
Practice Fax: 630-348-6278

1922276534 — DR. MARY EILEEN GLYNOS VANDERPLOW PSY.D.
Practice Location Address:

401 N MICHIGAN AVE # 1261
CHICAGO, IL
60611-4255

Practice Phone: 312-860-2420
Practice Fax:

1437446630 — PRECISION NEURODIAGNOSTICS LLC
Practice Location Address:

401 N MICHIGAN AVE , SUITE 1200
CHICAGO, IL
60611-4255

Practice Phone: 816-728-3674
Practice Fax: 312-753-5300

1225316581 — SHANA ONIELLA JACKSON LCSW
Practice Location Address:

401 N MICHIGAN AVE
CHICAGO, IL
60611-4255

Practice Phone: 312-798-9212
Practice Fax: 844-246-6796

1578988739 — JORDAN L ENGELMAN PA-C
Practice Location Address:

401 N MICHIGAN AVE , SUITE 1200
CHICAGO, IL
60611-4255

Practice Phone: 312-635-0973
Practice Fax:

Directions to “ STACY ERVIN APN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.