Mark A Stefaniuk, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-109698 Issued in IL

Practice address

3633 W Lake Ave Ste 108
Glenview, IL 60026-5801

Phone

(847) 510-2805

Fax

(847) 510-2806

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2026 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HFBJCD/Endpoint/HFBJCD

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.

• Lake County Acute Care, LLP

  • Family Medicine Physician
  • Gurnee, IL
  • NPI 1861599052
  NPD
• Pioneer Concierge Medicine, PLLC

  • Family Medicine Physician
  • Glenview, IL
  • NPI 1417676891
  NPD

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1013932409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE STE 108",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265801",
            "telephone_number": "847-510-2805",
            "fax_number": "847-105-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE STE 108",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265801",
            "telephone_number": "847-510-2805",
            "fax_number": "847-510-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANIUK",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "89349 (ID#)",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-109698",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036109698",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-109698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036109698-4",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036109698",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stark Inch Associates, Inc.
• Gregory Stasi, PH.D.
• Stacey Stasko
• Statewide Agency
• Jaclyn Elizabeth Stayback, PHARMD
• Charles William Steffy III, PTA
• Cheryl Ann Steiman, M.D.
• Julie Stein
• Maryann Joyce Stein, PTA
• Nicole Christine Steineke, MD

• Family Medicine Physician in Glenview, IL
• Providers in Glenview, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.