Staci Marie Clabough, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

344145 Issued in NY

Practice address

2960 Artesian Rd Ste 144
Naperville, IL 60564-4876

Phone

(630) 687-9206

Fax

(630) 675-1491

NPI assigned

Mar 4, 2019

Last updated

May 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Staci Jacobs Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1215495700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 FITZWILLIAM WAY",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421021",
            "telephone_number": "630-346-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 ARTESIAN RD STE 144",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644876",
            "telephone_number": "630-687-9206",
            "fax_number": "630-675-1491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "635 Belle Terre Rd Ste 209",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117771987",
            "country_code": "US",
            "telephone_number": "631-474-0707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLABOUGH",
        "first_name": "STACI",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.428259",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017721",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sjacobs@optionsmedicalweightloss.com",
            "affiliation": "N",
            "address_1": "2960 Artesian Rd Ste 144",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605644876",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sjacobs@optionsmedicalweightloss.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2960 Artesian Rd Ste 144",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605644876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "JACOBS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meaghan Ciciora
• Dan Ciechanowski, PT
• Vincent Cieslak, LCSW, CADC, CDVP
• City of Naperville Ill
• Melanie Jean Ciucci, LCSW
• Clarity Behavioral Consulting
• Emilie Rebecca Clark
• Licieara Clark
• Natasha L Clark, LCPC
• Sarah Clark

• Family Nurse Practitioner in Naperville, IL
• Providers in Naperville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.