Provider Demographics
NPI:1669574828
Name:FRANKLIN, STACEY ANN (DC)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:ANN
Last Name:FRANKLIN
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 1:533 AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:ISLAND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60042-9134
Mailing Address - Country:US
Mailing Address - Phone:847-865-5093
Mailing Address - Fax:847-865-5098
Practice Address - Street 1:533 AUBURN DR
Practice Address - Street 2:
Practice Address - City:ISLAND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60042-9134
Practice Address - Country:US
Practice Address - Phone:847-865-5093
Practice Address - Fax:847-865-5098
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232896OtherBCBS
IL02232896OtherBCBS
ILK25272Medicare ID - Type Unspecified