Stephen J Chadwick, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

036058535 Issued in IL

Practice address

101 W McKinley Ave
Enta Allergy, Head & Neck Institute
Decatur, IL 62522

Phone

(217) 876-3682

Fax

(217) 876-3345

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1104883735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "address_2": "GSBLL",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-2868",
            "fax_number": "217-876-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W MCKINLEY AVE",
            "address_2": "ENTA ALLERGY, HEAD & NECK INSTITUTE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62522",
            "telephone_number": "217-876-3682",
            "fax_number": "217-876-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHADWICK",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036058535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058535",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cep America Illinois Intensivists
• Cep America-Illinois Hospitalists, LLP
• Cepamerica Illinois LLP
• Lisa Cervantes
• Chad Burmeister D.M.D. P.C.
• Eleanore Sharon Chan, CF-SLP
• Dontesa Chandler
• Vineeta Chandra, MD
• Samitha C Chandraratne, M.D.
• Karin Chang, RPH

• Otolaryngology Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.