Individual provider Active NPI

Stephanie Marie Free, LICENSED ESTHETICIAN

  • Health Educator
  • Evergreen Park, IL
National Provider Identifier
1225825144
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
License
131010151 Issued in IL
Practice address
3317 W 95TH St Ste 4
Evergreen Park, IL 60805-2243
Phone
(312) 600-5592
NPI assigned
Apr 23, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X 131010151 IL Primary

Addresses

Primary practice location

3317 W 95TH St Ste 4
Evergreen Park, IL 60805-2243

Mailing address

9449 S Kedzie Ave Ste 342
Evergreen Park, IL 60805-2325
Phone (312) 600-5592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
131010151ILMDHealth Educator

Practice roles

OrganizationSpecialtyStatusNew patients
Bodii Cafe Incorporated Health Educator Current Accepting new patients

Locations

9449 S Kedzie Ave
Evergreen Pk, IL 60805
Phone (773) 420-3481

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1225825144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 S KEDZIE AVE STE 342",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052325",
            "telephone_number": "312-600-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 W 95TH ST STE 4",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052243",
            "telephone_number": "312-600-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREE",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "LICENSED ESTHETICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "IL",
            "license": "131010151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.