MRS. STACEY WEATHERS-CANNON (NPI# 1538771076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538771076 |
| Entity Type | Individual |
| Full Name | MRS. STACEY WEATHERS-CANNON |
| Practice Address |
650 Ingraham Ave Calumet City IL 60409-4236 |
| Mailing Address |
Po Box 647 Lansing IL 60438-0647 |
| Practice Telephone | 7085468208 |
| Mailing Telephone | 7085468208 |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| N | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
650 INGRAHAM AVE |
| City | CALUMET CITY |
| State | IL |
| Zip Code | 60409-4236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689159832 | Victory Pharmacy of Decatur Inc | Pharmacy | 1837 River Oaks Rd, Calumet City, IL 60409 | 2018-10-03 |
| 1801336961 | It's About Change Sober Living, Inc. | Community/Behavioral Health | 1604 Horbor St., Calumet City, IL 60409 | 2017-03-08 |
| 1750832986 | Jeffrey Mcneil | Social Worker | 660 Memorial Dr., Calumet City, IL 60409 | 2016-10-24 |
| 1578855219 | Cherechi V Onyenso | Nurse Practitioner | 1473 Ring Ring Road, Great Heights Family Medicine, Calumet City, IL 60409 | 2011-05-13 |
| 1205097607 | Michael Peter Weisberg | Ophthalmology | 1700 East West Road, Calumet City, IL 60409 | 2008-06-19 |
| 1861694333 | County of Cook | Local Education Agency (LEA) | 1255 Superior Ave, Calumet City, IL 60409 | 2007-06-05 |
| 1689875585 | Calumet City School District #155 | Local Education Agency (LEA) | Memorial Dr and Superior, Calumet City, IL 60409 | 2007-05-29 |
| 1932224185 | Micah K Swansey Sr. | Psychologist | 593 Burnham Avenue, Calumet City, IL 60409 | 2007-03-20 |
| 1184768210 | Beverly Williamson | Optometrist | 200 River Oaks Drive, Calumet City, IL 60409 | 2007-02-20 |
| 1205978863 | Dillons Dental Services LLC | Dentist | 2000 E 159th St, Calumet City, IL 60409 | 2007-02-12 |
| Find all providers in zip 60409 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154739803 | Micaela Sanchez | Specialist/Technologist | 1600 167th St, Calumet City, IL 60409 | 2014-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104438621 | Abril Malagon | Specialist/Technologist | 1 S Greenwood Ave, Palatine, IL 60074-6328 | 2020-08-17 |
| 1265050678 | Megan Elsbree | Specialist/Technologist | 11819 Deacon Dr, Rockton, IL 61072-9411 | 2020-07-13 |
| 1013534437 | Nicole Rose Mondelli | Specialist/Technologist | 958 Tallgrass Dr, Bartlett, IL 60103-5071 | 2020-07-01 |
| 1740806413 | Megan Herter | Specialist/Technologist | 1513 Old Ivy Dr, Springfield, IL 62711-8156 | 2020-06-18 |
| 1164047239 | Madison Stagman | Specialist/Technologist | 280 Douglas Ave Apt 4, Mascoutah, IL 62258-2963 | 2020-06-14 |
| 1588286272 | Sarah Wegrzyn | Specialist/Technologist | 3040 S Wabash Ave, Chicago, IL 60616-3474 | 2020-05-15 |
| 1336761386 | Christine Louise Shebelski | Specialist/Technologist | 15203 Pulaski Rd, Midlothian, IL 60445-3755 | 2020-05-13 |
| 1386266633 | Kathryn Riordan | Specialist/Technologist | 221 Triton Ln, Naperville, IL 60540-7926 | 2020-05-09 |
| 1487276747 | Vianey Hernandez-ramirez | Specialist/Technologist | 4115 Howard St, Skokie, IL 60076-3749 | 2020-05-09 |
| 1972124600 | Margaret G Heldt | Specialist/Technologist | 3000 Raffel Rd, Woodstock, IL 60098-8302 | 2020-05-05 |
| Find all providers with the same taxonomy | ||||
| City | CALUMET CITY |
| Zip Code | 60409 |
Please comment or provide details below to improve the information on MRS. STACEY WEATHERS-CANNON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.