Active NPI
Stephanie Larios, PA-C
- Physician Assistant
- Elgin, IL
National Provider Identifier
1033633946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085006297
- Practice address
- 2490 Bushwood Dr
Elgin, IL 60124-7898 - Phone
- (224) 293-5200
- NPI assigned
- Aug 1, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 085006297 | IL | Primary |
Addresses
Primary practice location
2490 Bushwood Dr
Elgin, IL 60124-7898
Mailing address
3211 W Belle Plaine Ave Apt 2a
Chicago, IL 60618-2326
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085006297 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Community Health Network | Current | Accepting new patients | |
| Access Community Health Network | Current | Accepting new patients | |
| Access Community Health Network | Past | Accepting new patients |
Locations
600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000
7200 S Ingleside Ave
Chicago, IL 60619
Phone (773) 324-6942
Organizations & group practices 5
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.
-
- Federally Qualified Health Center (FQHC)
- Des Plaines, IL
- NPI 1982783692
-
- Urgent Care Clinic/Center
- Chicago, IL
- NPI 1205814118
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1447321898
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1699701383
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1043398217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1033633946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3211 W BELLE PLAINE AVE APT 2A",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606182326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2490 BUSHWOOD DR",
"city": "ELGIN",
"state": "IL",
"postal_code": "601247898",
"telephone_number": "224-293-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARIOS",
"first_name": "STEPHANIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-01",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085006297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.