Staci L Nelson, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

041517712 Issued in IL

Practice address

41W400 Silver Glen Rd
St Charles, IL 60175-8453

Phone

(608) 220-2607

NPI assigned

Aug 29, 2023

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)

Not enrolled

Credentials

Registered Nurse

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.

• Silver Glen Road Opco LLC

  • Substance Abuse Rehabilitation Facility
  • St Charles, IL
  • NPI 1578187886
  NPD

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1639954555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41W400 SILVER GLEN RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601758453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41W400 SILVER GLEN RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601758453",
            "telephone_number": "608-220-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "STACI",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "041517712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisa Lynn Neary, LCSW
• Danielle Marie Nebel
• Patrice Neita
• Megan M Neitzel, MSW
• Alexander D Nelson, DPT
• Neurobeat LLC
• New and Bold Counseling, PLLC
• Edward M Newman, D.O.
• Pia Newman, RBT
• Megan Nguyen, PA

• Addiction (Substance Use Disorder) Registered Nurse in St Charles, IL
• Providers in St Charles, IL by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.