Valerie L Stout, CNM
Individual provider Active NPI Advanced Practice Midwife · Summit, IL
NPI 1104844885 · NPPES record last updated May 21, 2012
Key facts
- NPI
- 1104844885
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Advanced Practice Midwife 367A00000X
- License
- 209.008254 (IL)
- Practice address
- 7450 W 63Rd St
Summit, IL 60501-1816 - Phone
- (708) 458-0757
- Fax
- (708) 458-3784
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.008254 | IL | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Madison County General Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 209.008254 | IL | Yes |
Addresses
Primary practice location
7450 W 63Rd St
Summit, IL 60501-1816
Mailing address
7450 W 63Rd St
Summit, IL 60501-1816
Phone (708) 458-0757
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104844885 | Medicaid | IL |
Other providers in Summit, IL
- Ankit Kirit Shah
- Dilip Shah
- Kirit C Shah
- Nazeer Shaik
- Benjamin Silva
- Summit Behavioral Health
- Summit Dental Center LLC
- Summit Medical Center S.C.
- Summit Medical Pharmacy Inc
- Summit SCH Dist 104
All providers in Summit, IL · Advanced Practice Midwife in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.