Watson, Stacey Burrack

Watson, Stacey Burrack is an individual health care provider with primary practice located at 415 W Golf Rd Ste 16 , Arlington Heights IL 60005. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Watson, Stacey Burrack can be contacted via phone (847) 577-0904.

Contact Information

Primary practice address
415 W Golf Rd Ste 16 Arlington Heights IL 60005
Phone: (847) 577-0904
Fax: (847) 577-1558
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 180006108 Illinois

Profile Details

NPI number 1972629434
LBN Legal business name Watson, Stacey Burrack
Credentials LCPC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2007
Last updated Dec 5th, 2018 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1972629434 NPPES
Illinois Other 01635186 BCBS

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