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Individual
TIMOTHY STACY
Active
Individual
TIMOTHY STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
209031421
IL
363LF0000X
Family Nurse Practitioner
Primary
209031421
IL
Other
Enumeration date
01/17/2025
Last updated
04/30/2026
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