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Stacey M Thacker, PHARMD
Primary Care Clinic/Center in Edwardsville, Illinois
NPI 1962659664

Stacey M Thacker is a Primary Care Clinic/Center based in Edwardsville, IL and is specialized in Primary Care. Stacey M Thacker practices in Edwardsville, IL and has the professional credentials of PHARMD. The NPI Number for Stacey M Thacker is 1962659664 and holds a License No. 051292099 (Illinois).

The current practice location address for Stacey M Thacker is 200 University Park Dr, Edwardsville, IL and can be reached out via phone at 618-650-5131.

Location: 200 University Park Dr, Edwardsville, IL, 62026-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1962659664
Provider Name
Stacey M Thacker
Credential
PHARMD
Provider Entity Type
Individual
Gender
Female
Address
200 University Park Dr, Edwardsville, IL, 62026-0001
Phone Number
618-650-5131
Fax Number
Provider Enumeration Date
08/25/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
200 University Park Dr
City
Edwardsville
State
Illinois
Zip
62026-0001
Phone Number
618-650-5131
Fax Number
person
Provider Business Mailing Address Details
Address
200 University Park Dr
City
Edwardsville
State
Illinois
Zip
62026-0001
Phone Number
618-650-5131
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
051292099 (Illinois)
Definition
Definition to come...
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