Individual provider Active NPI

George Lane Stankevych, M.D.

  • Obstetrics & Gynecology Physician
  • McHenry, IL
National Provider Identifier
1053312934
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-060937 Issued in IL
Practice address
4119 W Shamrock LN
Suite 200
McHenry, IL 60050-8289
Phone
(815) 344-1611
Fax
(815) 344-1614
NPI assigned
Aug 2, 2005
Last updated
Mar 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-060937 IL Primary

Addresses

Primary practice location

4119 W Shamrock LN
Suite 200
McHenry, IL 60050-8289

Mailing address

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (815) 356-2323

Other practice location 1

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (815) 356-2323

Other identifiers 1

IdentifierTypeStateIssuer
036-060937OtherILSTATE LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gstankevych288373@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040326000044 IL Practitioner - Obstetrics/Gynecology 1557253465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4119 W Shamrock LN
Suite 200
McHenry, IL 60050-8268
Phone (815) 344-1611

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-060937ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Nov 1, 2021 Accepting new patients
George L Stankevych MD PC Obstetrics & Gynecology CurrentSince Jul 1, 1984 Accepting new patients
Central Dupage Physician Group CurrentSince Nov 1, 2021 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

10400 Haligus Rd
Huntley, IL 60142
Phone (224) 654-0000

4119 W Shamrock Ln
McHenry, IL 60050
Phone (815) 344-1611

4119 W Shamrock Ln
Ste 200
McHenry, IL 60050
Phone (815) 344-1611

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • Direct secure messaging: gstankevych288373@direct.myadvocateaurora.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1053312934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 HALIGUS RD",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429553",
            "telephone_number": "815-356-2323",
            "fax_number": "847-802-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 W SHAMROCK LN",
            "address_2": "SUITE 200",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508289",
            "telephone_number": "815-344-1611",
            "fax_number": "815-344-1614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 Haligus Rd",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429553",
            "country_code": "US",
            "telephone_number": "815-356-2323",
            "fax_number": "847-802-7201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANKEVYCH",
        "first_name": "GEORGE",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-060937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036-060937",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gstankevych288373@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4119 W Shamrock Ln",
            "address_2": "Suite 200",
            "city": "McHenry",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600508289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4119 W Shamrock Ln",
            "address_2": "Suite 200",
            "city": "McHenry",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600508289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.