Stacy Kannenberg
Stacy Kannenberg is a Student in an Organized Health Care Education/Training Program in Peoria Heights, Illinois. Licensed in Illinois. Registered with an NPI since 2025.
- Licensed in
- IL
- In the registry since
- 2025
- Specialties on file
- 2
Practice location Address checks out
1516 E Kelly AvePeoria Heights, IL 61616-6512
Phone: (309) 657-8779
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X (IL) |
|---|---|
| Athletic Trainer | Taxonomy 2255A2300X (IL) |
Record details
| NPI number | 1790649986 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | December 11, 2025 |
| Last updated in NPPES | December 11, 2025 |
| Certification date | December 11, 2025 |
| Mailing address | 1516 E Kelly Ave, Peoria Heights, IL 61616-6512 |
Other providers in Peoria Heights
-
Jennifer Lynn Kroll
1317 E Kelly Ave, Peoria Heights, IL 61616 · (414) 899-4563