Individual provider Active NPI

Patricia C Stec, M.D.

  • Pediatrics Physician
  • Northfield, IL
National Provider Identifier
1053416123
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-067406 Issued in IL
Practice address
250 Maple Row
Northfield, IL 60093-1035
Phone
(847) 446-8341
NPI assigned
Sep 14, 2006
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-067406 IL Primary

Addresses

Primary practice location

250 Maple Row
Northfield, IL 60093-1035

Mailing address

250 Maple Row
Northfield, IL 60093-1035
Phone (847) 446-8341

Other identifiers 4

IdentifierTypeStateIssuer
0021648920OtherILEXISTING BCBS PROVIDER #
12-00920OtherUNITED HEALTH CARE
4028503OtherAETNA
036067406MedicaidIL

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
I20160105001600 IL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0547562738

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-067406ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkside Pediatrics, S.C. Pediatrics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1053416123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MAPLE ROW",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600931035",
            "telephone_number": "847-446-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MAPLE ROW",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600931035",
            "telephone_number": "847-446-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEC",
        "first_name": "PATRICIA",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-067406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXISTING BCBS PROVIDER #",
            "identifier": "0021648920",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "12-00920",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4028503",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036067406",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

Verify at the official NPI Registry.