Search › Illinois › 343900000X
Kendall Stacker
NPI 1831529239 · on the registry since 2013 · sole proprietor
Practice
- Address
- 2745 Brookmeadow Dr
Belleville, IL 62221 - Phone
- (618) 257-3090
- Fax
- (618) 257-3090
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Also registered as
- 343900000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-11-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois