Individual
ANDREA MICHELLE STACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
311 E CULLERTON ST UNIT 3, CHICAGO, IL 60616-4323
(312) 399-0933
Mailing address
311 E CULLERTON ST UNIT 3, CHICAGO, IL 60616-4323
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056003713
IL
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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