Individual provider Active NPI

Emily N Stouffer, NP-C

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1063728202
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.008183 Issued in IL
Practice address
1611 W Harrison St
Suite 400
Chicago, IL 60612-4861
Phone
(312) 243-4244
Fax
(312) 942-1517
NPI assigned
Aug 25, 2010
Last updated
Oct 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.008183 IL Primary

Addresses

Primary practice location

1611 W Harrison St
Suite 400
Chicago, IL 60612-4861

Mailing address

1611 W Harrison St
Suite 300
Chicago, IL 60612-4861
Phone (312) 243-4244

Other identifiers 4

IdentifierTypeStateIssuer
1633878OtherILBCBS IL
202735OtherILPTAN LOCALITY 15
215827OtherILPTAN LOCALITY 99
604530OtherILPTAN LOCALITY 16

Other names 1

  • Emily N Dittle Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100920000258 IL Practitioner - Nurse Practitioner 6103941745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

1611 W Harrison St
Suite 400
Chicago, IL 60612-4861
Phone (877) 632-6637

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.008183ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince Aug 20, 2012 Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush, LLC CurrentSince Aug 20, 2012 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Great Lakes Eye Consultants PLC PastSince Sep 1, 2004 Accepting new patients
Orthopaedic Surgery Specialists LTD Past Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

963 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 725-8425

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Interoperability endpoints

  • Direct secure messaging: emily.stouffer.1@12576.direct.athenahealth.com

Organizations & group practices 7

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 5

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": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1063728202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "address_2": "SUITE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-243-4244",
            "fax_number": "312-942-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "address_2": "SUITE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-243-4244",
            "fax_number": "312-942-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUFFER",
        "first_name": "EMILY",
        "middle_name": "N",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-25",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.008183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "1633878",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN LOCALITY 15",
            "identifier": "202735",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN LOCALITY 99",
            "identifier": "215827",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN LOCALITY 16",
            "identifier": "604530",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "DITTLE",
            "middle_name": "N",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.