Individual
STACY WENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DTHS
Contact information
Practice address
611 W PARK, URBANA, IL 61801-2500
(217) 326-2911
(217) 344-8047
Mailing address
611 W PARK, URBANA, IL 61801-2500
(217) 326-2911
(217) 344-8047
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK
IL
01
—
203
BLUE CROSS
IL
01
—
4117
HEALTH ALLIANCE
IL
01
—
7216
PERSONAL CARE
IL
Enumeration date
04/18/2008
Last updated
04/18/2008
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