| Doctor Name: | KRISTINE N. STACY |
| NPI Number: | 1255387312 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 765 Ela Rd Suite 305 Lake Zurich, IL - 600472337 |
| Business Phone Number: | 8474380181 |
| Business Fax Number: | |
| Mailing Address: | 520 E 22nd St, LOMBARD |
| State: | IL |
| Postal Code: | 601486110 |
| Phone Number: | 6308742542 |
| Fax Number: | 6308742642 |
| NPI Enumeration Date: | 05/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471N0900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Nuclear Medicine Technology |
| Taxonomy Definition: | |