Staci R Young
MD | Pediatrics | Female
Staci R Young, MD is a Glen Carbon, Illinois based Pediatric doctor with medical specialization in
General Pediatrics. Staci R Young is also known as
Staci R Johnson.
Current practice location of Staci R Young is
4804 S State Route 159, Glen Carbon, Illinois - 62034-1904. She can be contacted on phone at
618-288-9305 and fax number 618-288-9308.
Staci R Young is a sole proprietor of her business.
NPI number (Unique professional ID) for Staci R Young is
1053406694 which was assigned by NPPES on 03 Oct, 2006 and it was last updated on 29 Jun, 2020.
Staci R Young license number is
036113846 for Pediatrics (208000000X) in Illinois.
Staci R Young is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Staci R Young basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Staci R Young |
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| Other Name : | Staci R Johnson |
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| Credential : | MD |
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| Gender : | Female |
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| Sole Proprietor : | Yes |
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Business Address:
Staci R Young address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 4804 S State Route 159
Glen Carbon, IL, 62034-1904
United States |
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| Phone Number : | 618-288-9305 |
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| Fax Number : | 618-288-9308 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1053406694 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 03 Oct, 2006 |
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| Last Updated On : | 29 Jun, 2020 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Staci R Young are as mentioned. Primary taxonomy code for Staci R Young, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 036113846 | IL |
| 208000000X | Pediatrics | No | 2005020858 | MO |
Legacy Identifiers:
Other legacy medical identifiers of Staci R Young such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 06500123 | MEDICAID | IL | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 4804 S State Route 159
Glen Carbon, IL, 62034-1904
United States |
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| Phone Number : | 618-288-9305 |
|---|
| Fax Number : | 618-288-9308 |
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Business Location:
Patients can refer following map for directions to
Staci R Young practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.