Individual
STACIE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 N MCLEAN BLVD STE I, ELGIN, IL 60123-1782
(847) 695-3680
Mailing address
1101 RITTER ST UNIT 202, NORTH AURORA, IL 60542-8957
(630) 777-0629
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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