Bennis, Stacey Anne
Bennis, Stacey Anne is an individual health care provider with primary practice located at 2160 S 1St Ave Ste 1700 , Maywood IL 60153-3328. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Bennis, Stacey Anne can be contacted via phone (888) 584-7888.Contact Information
Primary practice address
2160 S 1St Ave Ste 1700
Maywood IL 60153-3328
Phone: (888) 584-7888
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 125-063353 | Illinois |
Allopathic & Osteopathic Physicians / Sports Medicine | 2081S0010X | 036146120 | Illinois |
Profile Details
NPI number | 1265870695 |
---|---|
LBN Legal business name | Bennis, Stacey Anne |
Credentials | M.D., CAQ-SM |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 7th, 2013 |
Last updated | Oct 25th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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