Provider Demographics
NPI:1861893208
Name:SANDROCK GRABSKY, STACI ANN (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:STACI
Middle Name:ANN
Last Name:SANDROCK GRABSKY
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1644 BRENTFORD DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1350
Mailing Address - Country:US
Mailing Address - Phone:630-569-4795
Mailing Address - Fax:
Practice Address - Street 1:1250 S NAPER BLVD
Practice Address - Street 2:1644 BRENTFORD DR.
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8312
Practice Address - Country:US
Practice Address - Phone:630-527-9100
Practice Address - Fax:630-527-9129
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL227.010749225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist