Individual
STEPHANIE E SPICER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
19900 GOVERNORS DR STE 102, OLYMPIA FIELDS, IL 60461
(708) 957-3338
(708) 856-0340
Mailing address
19900 GOVERNORS DR STE 102, OLYMPIA FIELDS, IL 60461-1060
(708) 957-3338
(708) 856-0340
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004673
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004673
—
IL
01
—
01626972
BCBS
IL
01
—
4024810001
DMERC
IL
01
—
P00080285
RAILROAD MEDICARE
IL
Enumeration date
07/04/2006
Last updated
12/09/2021
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