Organization
STACI R YOUNG MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACI R YOUNG MD (OWNER)
(618) 655-0015
Entity
Organization
Contact information
Practice address
3 SUNSET HILLS PROFESSIONAL CTR STE D, EDWARDSVILLE, IL 62025-3760
(618) 655-0015
(618) 655-0016
Mailing address
PO BOX 621, EDWARDSVILLE, IL 62025-0621
(618) 692-9640
(618) 692-9643
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
IL
Other
Enumeration date
11/14/2006
Last updated
02/04/2008
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