Staci R Young is a Pediatrics in Glen Carbon, Illinois. Staci R Young practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Staci R Young is 1053406694. The last update date is 2020-06-29.
Staci R Young's current location address is 4804 S State Route 159, Glen Carbon, Illinois. You can contact this provider via phone number 6182889305 and fax number 6182889308. The mailing address for Staci R Young is 4804 S State Route 159, Glen Carbon, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Staci R Young |
|---|---|
| Address | 4804 S State Route 159, Glen Carbon, Illinois |
| Phone Number | 6182889305 |
| Fax Number | 6182889308 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1053406694 |
|---|---|
| Provider Enumeration Date | 2006-10-03 |
| Last Updated Date | 2020-06-29 |
Provider Mailing Address Detail
| Address | 4804 S State Route 159 |
|---|---|
| City | Glen Carbon |
| State | Illinois (IL) |
| Post Code | 620341904 |
| Phone Number | 6182889305 |
| Fax Number | 6182889308 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 208000000X |
| Licence No | 2005020858 |
|
Definition: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6500123 | IL | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Staci R Young by the Centers for Medicare & Medicaid Services?
The Staci R Young has been assigned the NPI (National Provider Identifier) 1053406694 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Staci R Young?
The Staci R Young is physically situated at 4804 S State Route 159, in the city of Glen Carbon, state of IL, with the postal code 620341904.
What is the Staci R Young's specialty and taxonomy code?
The Staci R Young's specialty is Pediatrics, and the corresponding taxonomy code is 208000000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1053406694 to Staci R Young?
The Centers for Medicare & Medicaid Services originally issued the 1053406694 to Staci R Young on 2006-10-03.
When was the information pertaining to Staci R Young most recently updated or revised?
The details related to Staci R Young, including its address, specialty, and other relevant information, were last updated or revised on 2020-06-29.