Steven John Antonini, MD
Individual provider Active NPI Pediatrics Physician · Mokena, IL
NPI 1114004652 · NPPES record last updated Mar 1, 2022
Key facts
- NPI
- 1114004652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 036076951 (IL)
- Practice address
- 21205 Owens Rd Ste 3
Mokena, IL 60448-2023 - Phone
- (815) 469-2123
- Fax
- (815) 469-2149
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Loyola University of Chicago, Stritch School of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Health Service Systems, Inc
Practice addresses (Care Compare)
1890 Silver Cross Blvd
Suite 265
New Lenox, IL 60451-9623
Phone (815) 727-4292
1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Hospital & facility affiliations
- Silver Cross Hospital and Medical Centers
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101102001503 | IL | Practitioner - Pediatric Medicine |
9436172525 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-076951 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Service Systems, Inc | Current |
Accepting new patients | |
| Health Service Systems, Inc | Internal Medicine | Current |
Accepting new patients |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
21205 Owens Rd
Ste 3
Mokena, IL 60448
Phone (815) 469-2123
21202 Owens Rd
Ste 101
Mokena, IL 60448
Phone (779) 334-0030
1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BFFABA/Endpoint/BFFABA
- steven.antonini@hcsc.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036-076951 | IL | |
| Internal Medicine Physician | 207R00000X | 036076951 | IL | |
| Pediatrics Physician | 208000000X | 036076951 | IL | Yes |
Addresses
Primary practice location
21205 Owens Rd Ste 3
Mokena, IL 60448-2023
Mailing address
21205 Owens Rd Ste 3
Mokena, IL 60448-2023
Phone (815) 469-2123
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09915014 | Other | IL | BLUE CROSS BLUE SHIELD |
| 036076951 | Medicaid | IL | |
| 649420 | Other | MEDICARE PROV # |
Other providers in Mokena, IL
- Ams Counseling
- Amy Busse LCPC LLC
- Angela Marie Andrus
- Holly Nichole Andrzeicik
- Kristie Ansinn
- Luis F. Aragon
- Julianne Armstrong
- Assured Choice Health Care LLC
- Assured Choice Home Health LLC
- At Home Health Services, LLC
All providers in Mokena, IL · Pediatrics Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.