STACEY M THACKER


Address: 200 University Park Dr, Campus Box 2000, Edwardsville, IL 62026-0001
Phone: 6186505131

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
051292099 IL Ambulatory Health Care Facilities

Other Providers STACEY THACKER

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

Office Location

Street Address 200 UNIVERSITY PARK DR
CAMPUS BOX 2000
City EDWARDSVILLE
State IL
Zip Code 62026-0001

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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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
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Competitor

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City EDWARDSVILLE
Zip Code 62026

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Dataset Information

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.

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