Stephen Dennis Northrop, D.D.S., M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

036087093 Issued in IL

Practice address

12865 W Audrey Ave
Beach Park, IL 60087-3444

Phone

(218) 349-7058

NPI assigned

Oct 19, 2010

Last updated

Oct 19, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1164732525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558041800",
            "telephone_number": "218-349-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12865 W AUDREY AVE",
            "city": "BEACH PARK",
            "state": "IL",
            "postal_code": "600873444",
            "telephone_number": "218-349-7058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHROP",
        "first_name": "STEPHEN",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29638",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036087093",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "38583020",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "81051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danica Jenice Coranez Malo, LPC
• Jesse-Jay Manansala, PMHNP-BC
• Maves Medical LTD
• Lauren H Moller
• Allison Sheridan Myers, M.A., CCC-SLP
• John T Patenaude, DC
• Lanea Patton
• Monica Phelps, LPN
• David P Picchietti, DC
• Sumer Porter

• Neurology Physician in Beach Park, IL
• Providers in Beach Park, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.