Individual provider · Type 1 NPI
Stacy Bly
Specialist · Chicago, IL
NPI number
1164744652
Active
Practice location
663 W Grace St
Chicago, IL 60613-4026
Mailing address
663 W Grace St Apt 306
Chicago, IL 60613-4024
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 070009463 (IL) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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About NPI 1164744652
Stacy Bly's National Provider Identifier is 1164744652, issued on Feb 24, 2010. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Chicago, IL. The record was last updated on May 17, 2010.