# STACIE D MCCLANE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1245258490
- **Gender:** F
- **Credential:** D.R.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | 036-106591 | IL | Yes |
| 2082S0099X | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | 036-106591 | IL | — |

## Other

- **Enumeration date:** 07/17/2006
- **Last updated:** 04/25/2014