Provider Demographics
NPI:1831665074
Name:PROPP, STACY (DACM, LAC)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:PROPP
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 W LYNDALE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-3345
Mailing Address - Country:US
Mailing Address - Phone:773-251-0461
Mailing Address - Fax:
Practice Address - Street 1:1845 S MICHIGAN AVE
Practice Address - Street 2:CHICAGO INHEALTH CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616
Practice Address - Country:US
Practice Address - Phone:312-414-1088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001424171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist