Individual
DR. STACY ELISE BEUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
7310 W NORTH AVE STE 2H, ELMWOOD PARK, IL 60707-4212
(708) 456-3232
(708) 456-3371
Mailing address
1728 W ROSCOE ST APT 3E, CHICAGO, IL 60657-1082
(708) 456-3232
(708) 456-3371
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633693
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
09/27/2006
Last updated
07/08/2007
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