Individual
LILY STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 HOBART AVE, DOWNERS GROVE, IL 60516-3427
(630) 442-2024
Mailing address
1140 HOBART AVE, DOWNERS GROVE, IL 60516-3427
(630) 442-2024
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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