Individual ProviderStacie KempSocial WorkerBehavioral Health & Social Service ProvidersPractice Address325 Illinois Rt 2, Dixon, IL 61021-9118(815) 284-6611(414) 531-1652PECOS EnrollmentBased on the most recent information from CMS, provider Stacie Kemp does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1710361183Provider TypeIndividualFull NameKemp, StacieGenderFemaleSole ProprietorNoEnumeration Date7/16/2015Last Updated7/16/2015Contact InformationPractice LocationPractice Address325 Illinois Rt 2, Dixon, IL 61021-9118Phone(815) 284-6611FaxUnlisted FaxMailing LocationMailing Address4117 W Pebble Beach Ct, Franklin, WI 53132-9479Phone(414) 531-1652FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense149010053IllinoisCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense7369-123Wisconsin