Most Relevant Information
Provider Data
| NPI Number: | 1003231689 |
| Provider Name: | STACY ERVIN APN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209011244 |
Most Important Dates
| Enumeration Date: | 02/19/2014 |
| Last Updated: | 02/19/2014 |
Provider Practice Location
401 N MICHIGAN AVE
CHICAGO
IL
606114255
Practice Location Phone/Fax
| Phone: | 8668253227 |
| Fax: |
Provider Mailing Location
161 WASHINGTON ST FL 14
EIGHT TOWER BRIDGE, SUITE 1400
CONSHOHOCKEN
PA
194282083
Provider Mailing Phone/Fax
| Phone: | 8668253227 |
| Fax: |