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Contact Information

STACEY A BENNIS, M.D., CAQ-SM
2160 S. FIRST AVE.
MAYWOOD, IL60153
 Phone: 888-584-7888
 Fax:
 Website: https://www.zocdoc.com/doctor/stacey-bennis-md-272578
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for STACEY A BENNIS · (Female)

NPI # 1265870695
Status Active
Credentials M.D., CAQ-SM
Entity Individual
Enumeration date 06/07/2013
Last updated 10/25/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036146120
  • IL License # 125-063353
Hospital affiliation(s)
  • LOYOLA UNIVERSITY MEDICAL CENTER - (Acute Care)
    2160 S 1ST AVENUE
    MAYWOOD, IL 60153
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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