Individual
TOM DAVIS STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1550 N RANDALL RD, ELGIN, IL 60123-7876
(815) 398-9491
(815) 381-7498
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036125166
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE6001
RAILROAD MEDICARE -
IL
01
—
CG2631
RAILROAD MEDICARE - MCHENRY COUNTY
IL
Enumeration date
08/15/2008
Last updated
08/09/2023
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