STACEY M THACKER (NPI# 1962659664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962659664 |
Entity Type | Individual |
Full Name | STACEY M THACKER |
Credential | PHARM D |
Practice Address |
200 University Park Dr Campus Box 2000 Edwardsville IL 62026-0001 |
Practice Telephone | 6186505131 |
Enumeration Date | 2008-08-25 |
Last Update Date | 2008-08-25 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
051292099 | IL | Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962500553 | Stacey B Thacker | Marriage & Family Therapist | 1879 E Fir Ave, Ste 103 Roubicek & Shaw Counseling, Fresno, CA 93720 | 2006-09-20 |
Street Address |
200 UNIVERSITY PARK DR CAMPUS BOX 2000 |
City | EDWARDSVILLE |
State | IL |
Zip Code | 62026-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861018301 | Kari Kristine Hullinger | Student in an Organized Health Care Education/Training Program | Alumni Hall Room 2117, Edwardsville, IL 62026-0001 | 2020-06-21 |
1962028407 | Melissa Welge | Student in an Organized Health Care Education/Training Program | Southern Illinois University 6 Hairpin Dr, Edwardsville, IL 62026-0001 | 2020-06-21 |
1447876974 | Bailey Johnston | Student in an Organized Health Care Education/Training Program | 1 Hairpin Dr, Edwardsville, IL 62026-0001 | 2020-06-20 |
1649896374 | Abigail Kirstie Brohammer | Student in an Organized Health Care Education/Training Program | Siue School of Nursing Alumni Hall Room 2117, Edwardsville, IL 62026-0001 | 2020-06-18 |
1609498633 | Jenny Lieu | Student in an Organized Health Care Education/Training Program | 1 Hairpin Drive, Edwardsville, IL 62026-0001 | 2020-05-13 |
1174858005 | Sheryl L Salaris | Psychiatry & Neurology | Siue Health Counseling Services, Student Success Center, Rm. 0220, Edwardsville, IL 62026-0001 | 2009-10-09 |
1427182658 | Brian Shin | Dentist | 195 University Park Dr, Edwardsville, IL 62026-0001 | 2007-03-16 |
1164490736 | Gerald L Schlemer | Specialist/Technologist | Southern Illinois University Edwardsville, Campus Box 1129 Athletics, Edwardsville, IL 62026-0001 | 2006-03-09 |
1245847276 | Mai-linh Thi Nguyen | Student in an Organized Health Care Education/Training Program | 1 Hairpin Dr, Edwardsville, IL 62026-0001 | 2020-09-24 |
1093331530 | Aubrey Lynn Ferris Parnell | Student in an Organized Health Care Education/Training Program | 1 Hairpin Drive, Edwardsville, IL 62026-0001 | 2020-06-21 |
Find all providers in zip 62026 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689128399 | Wecare Tlc - Wwt Il Family Health Center | Clinic/Center | 3951 Lakeview Corprt Dr, Edwardsville, IL 62025-2801 | 2016-08-10 |
NPI | Name | Taxonomy | Address | Enumeration |
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1033724901 | Ar Healthcare | Clinic/Center | 11 E Main St Ste A, St Charles, IL 60174-1925 | 2020-09-08 |
1568073674 | Downers Grove Immediate Care Inc. | Clinic/Center | 425 Ogden Ave, Downers Grove, IL 60515-3066 | 2020-08-12 |
1538792221 | Greenbax Health Solutions, LLC | Clinic/Center | 4922 W Chicago Ave, Chicago, IL 60651-3142 | 2020-02-20 |
1548808728 | Unitypoint Health At Work | Clinic/Center | 1100 13th Ave, East Moline, IL 61244-1455 | 2019-12-18 |
1265076749 | Inhome Primecare LLC | Clinic/Center | 6738 N Lockwood Ave, Lincolnwood, IL 60712-3107 | 2019-10-29 |
1033760780 | Careatc | Clinic/Center | 600 S Michigan Ave # 402, Chicago, IL 60605-1900 | 2019-09-24 |
1356814503 | Thompson Medical Incorporated | Clinic/Center | 933 E Hyde Park Blvd Ste G, Chicago, IL 60615-2722 | 2019-01-09 |
1598248106 | Granite City Clinic Corp | Clinic/Center | 602 Farrish St, Madison, IL 62060-1567 | 2018-09-10 |
1497251037 | Thomas L Pitts, Md LLC | Clinic/Center | 233 E Erie St Ste 702, Chicago, IL 60611-5933 | 2018-04-03 |
1013438704 | Emily Byars | Clinic/Center | 1111 Greenfield Circle, Geneva, IL 60134 | 2017-07-03 |
Find all providers with the same taxonomy |
City | EDWARDSVILLE |
Zip Code | 62026 |
Please comment or provide details below to improve the information on STACEY M THACKER.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.