DR. CYNTHIA VERONICA STACK MD NPI 1447264932

NPI Information

NPI: 1447264932
Provider Name: DR. CYNTHIA VERONICA STACK, MD
Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Individual

Specialization: Neurology with Special Qualifications in Child Neurology

PECOS Registration: Yes

Address:
2300 CHILDRENS PLAZA
CHILDRENS MEMORIAL HOSPITAL #52
CHICAGO, IL
ZIP 60614
Phone: (773) 880-4352
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DR. Cynthia Veronica Stack, MD is a neurology with special qualifications in child neurology psychiatry neurology in Chicago, IL. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. DR. Cynthia Veronica Stack, MD NPI is 1447264932. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2300 CHILDRENS PLAZA
CHILDRENS MEMORIAL HOSPITAL #52
CHICAGO, IL
ZIP 60614
Phone: (773) 880-4352
Fax: (773) 880-3896

The NPI 1447264932 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/28/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	036051310	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	D15816	MEDICARE UPIN
2	P08799	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS
3	036051310	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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