David Eugene Stiasny, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036132909 Issued in IL

Practice address

5215 N California Ave Ste 601
Chicago, IL 60625-8564

Phone

(773) 878-3627

Fax

(773) 989-1669

NPI assigned

Nov 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Pediatrics

  Medicare reassignment NPD
• Swedish Covenant Management Services, Inc.

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1760432348

  Pediatrics

  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Swedish Covenant Management Services, Inc

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1962049551
  NPD

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1043491426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE STE 601",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606258564",
            "telephone_number": "773-878-3627",
            "fax_number": "773-989-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE STE 601",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606258564",
            "telephone_number": "773-878-3627",
            "fax_number": "773-989-1669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 N Westmoreland Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "IL",
            "postal_code": "600451659",
            "country_code": "US",
            "telephone_number": "847-535-6840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIASNY",
        "first_name": "DAVID",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301090550",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036132909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dstiasny277173@direct.northshore.org",
            "affiliation": "N",
            "address_1": "5215 N California Ave Ste 601",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606258564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Talia Stewart
• Tatum Megumi Stewart, MSW, LCSW
• Tiffani Cherhys Stewart, PA-C
• Zayda Stewart, LCSW
• Anne M Stey, MD
• Charles Joseph Stiava, PHD
• Stacy Marie Stibb, D.O.
• Karen Helene Stickler, PSY.D.
• Luke Stickler, PHARMD, AAHIVP
• Jennifer Rene Stickney, RPH

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.

Verify at the official NPI Registry.