Individual provider Active NPI

Stephen M Odon, DNP, APRNC-AG

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1285268417
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209020928 Issued in IL
Practice address
201 E Huron St FL 9
Chicago, IL 60611-3197
Phone
(312) 926-2441
Fax
(312) 926-9624
NPI assigned
Feb 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209020928 IL Primary

Addresses

Primary practice location

201 E Huron St FL 9
Chicago, IL 60611-3197

Mailing address

201 E Huron St FL 9
Chicago, IL 60611-3197
Phone (312) 926-2441

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sodon@nm.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200805000218 IL Practitioner - Nurse Practitioner 3678998838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jun 29, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 29, 2020 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

251 E Huron St
Chicago, IL 60611

201 E Huron St
Fl 9
Chicago, IL 60611
Phone (312) 926-2441

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1285268417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E HURON ST FL 9",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113197",
            "telephone_number": "312-926-2441",
            "fax_number": "312-926-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E HURON ST FL 9",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113197",
            "telephone_number": "312-926-2441",
            "fax_number": "312-926-9624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODON",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DNP, APRNC-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209020928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sodon@nm.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "251 E Huron St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606112908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.