Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Staci R Young, MD

Individual provider Pediatrics Physician · NPI 1053406694

Staci R Young, MD is a Pediatrics Physician in Glen Carbon, Illinois. Practices as a sole proprietor. Licensed in Illinois and Missouri.

Licensed in
IL, MO
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4804 S State Route 159
Glen Carbon, IL 62034-1904
Phone: (618) 288-9305
Fax: (618) 288-9308
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 036113846 (IL)
Pediatrics Physician Taxonomy 208000000X · Licence 2005020858 (MO)

Record details

NPI number1053406694
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 3, 2006
Last updated in NPPESJune 29, 2020
Certification dateJune 29, 2020
Mailing address4804 S State Route 159, Glen Carbon, IL 62034-1904

Other providers in Glen Carbon