Individual provider Active NPI

Stephanie Lynn Hallquist, OTR

  • Occupational Therapist
  • Plainfield, IL
National Provider Identifier
1073642328
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.007894 Issued in IL
Practice address
23915 W Main St
Suite C
Plainfield, IL 60544-1967
Phone
(815) 577-8844
NPI assigned
Mar 4, 2007
Last updated
Dec 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.007894 IL Primary

Addresses

Primary practice location

23915 W Main St
Suite C
Plainfield, IL 60544-1967

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other names 1

  • Stephanie Lynn Ebener Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216000625 IL Practitioner - Occupational Therapist in Private Practice 6507054673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2525 Kaneville Rd
Geneva, IL 60134-2578
Phone (847) 468-1400

Merit-based Incentive Payment System (MIPS)

Final score
81.69 of 100Reported as group
Quality
74.66
Promoting interoperability
100
Improvement activities
40
Cost
64.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.007894ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Orthopaedic Associates, PLLC Current Accepting new patients
Fox Valley Orthopaedic Associates, S.C. CurrentSince Dec 6, 2021 Accepting new patients
Fox Valley Orthopaedic Associates, PLLC Current Accepting new patients

Locations

1444 N Farnsworth Ave
Ste 101
Aurora, IL 60505

2525 Kaneville Rd
Geneva, IL 60134
Phone (630) 584-1400

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.

NPI Registry JSON

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1073642328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23915 W MAIN ST",
            "address_2": "SUITE C",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605441967",
            "telephone_number": "815-577-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLQUIST",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-04",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.007894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "EBENER",
            "middle_name": "LYNN",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.