Provider Demographics
NPI:1891838777
Name:AHRENS, STACI (DC)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:
Last Name:AHRENS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 N EOLA RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-9409
Mailing Address - Country:US
Mailing Address - Phone:630-499-8804
Mailing Address - Fax:630-499-9898
Practice Address - Street 1:1222 N EOLA RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-9409
Practice Address - Country:US
Practice Address - Phone:630-499-8804
Practice Address - Fax:630-499-9898
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor