Stacey Anna Spiller, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.013436 Issued in IL

Practice address

719 W Lake Ave
Peoria, IL 61614-5941

Phone

(309) 691-9355

Fax

(309) 691-9357

NPI assigned

Apr 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Natural Balance Wellness Center

  • Chiropractor
  • Peoria, IL
  • NPI 1235484973
  NPD

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1598930760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 W LAKE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145941",
            "telephone_number": "309-691-9355",
            "fax_number": "309-691-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 W LAKE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145941",
            "telephone_number": "309-691-9355",
            "fax_number": "309-691-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPILLER",
        "first_name": "STACEY",
        "middle_name": "ANNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.013436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Wade Sperry, RPH
• Ethan Sperry
• Susan Sphar, CNM
• John Robert Spigelmyer, D.D.S.
• Unique Spikesrogers
• Eric M Spires, RPH
• Nicole Spore
• Penny Rene Spradlin, PTA
• Sprinfield Clinic LLP
• Ladean Lee Spring, D.C.

• Physical Therapist in Peoria, IL
• Providers in Peoria, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.