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Individual

STACY MARIE STIBB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
355 E ERIE ST, CHICAGO, IL 60611-3167
(312) 238-1000
(312) 238-1208
Mailing address
355 E ERIE ST, CHICAGO, IL 60611-3167
(312) 238-1000
(312) 238-1208

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036172318
IL
208100000X
Physical Medicine & Rehabilitation Physician
OS12718
FL
2081P0010X
Pediatric Rehabilitation Medicine Physician
66532
WI
2081P0010X
Pediatric Rehabilitation Medicine Physician
OS12718
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
012186500
FL
05
1932348059
WI
01
HW118Z
MEDICARE PTAN
FL
Enumeration date
02/12/2009
Last updated
01/16/2025
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