Fredericks, Stacey Lynn

Fredericks, Stacey Lynn is an individual health care provider with primary practice located at 4700 W 95Th St Ste 205 , Oak Lawn IL 60453-2574. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Fredericks, Stacey Lynn can be contacted via phone (708) 684-7999.

Contact Information

Primary practice address
4700 W 95Th St Ste 205 Oak Lawn IL 60453-2574
Phone: (708) 684-7999
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.025334 Illinois

Profile Details

NPI number 1023360989
LBN Legal business name Fredericks, Stacey Lynn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2012
Last updated Feb 28th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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