Individual provider Active NPI

Stephen Salvatore Stabile, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1295756344
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-083665 Issued in IL
Practice address
1431 N Western Ave
Chicago, IL 60622-1797
Phone
(312) 633-5841
Fax
(312) 491-5020
NPI assigned
Jul 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-083665 IL Primary

Addresses

Primary practice location

1431 N Western Ave
Chicago, IL 60622-1797

Mailing address

5245 N Magnolia Ave
Chicago, IL 60640-2202
Phone (773) 671-5178

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309000426 IL Practitioner - Family Practice 6507754751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primecare Community Health, Inc.Group PAC ID 6204722077, 41 clinicians

Practice addresses (Care Compare)

1431 N Western Ave
Suite 406
Chicago, IL 60622-1774
Phone (312) 491-5495

Hospital & facility affiliations

  • Presence Saints Mary and Elizabeth Medical Center Hospital, Chicago, IL, CCN 140180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-083665ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare Community Health, Inc. Family Medicine CurrentSince Oct 21, 2013 Accepting new patients
Primecare Community Health Inc CurrentSince Oct 21, 2013 Accepting new patients
Primecare Community Health, Inc. Family Medicine Current Accepting new patients
Primecare Community Health, Inc. Family Medicine Current Accepting new patients
Primecare Community Health Inc Past Accepting new patients

Locations

1431 N Western Ave
Ste 401
Chicago, IL 60622
Phone (312) 633-5841

1127 N Oakley Blvd
Fl 2
Chicago, IL 60622
Phone (312) 633-5841

1431 N Western Ave
Chicago, IL 60622
Phone (312) 633-5866

1431 N Western Ave
Ste 406
Chicago, IL 60622
Phone (312) 491-5495

1127 N Oakley Blvd
#2
Chicago, IL 60622

Interoperability endpoints

  • Direct secure messaging: stephen.stabile.1@16494.direct.athenahealth.com

Organizations & group practices 5

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1295756344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 N MAGNOLIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402202",
            "telephone_number": "773-671-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221797",
            "telephone_number": "312-633-5841",
            "fax_number": "312-491-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STABILE",
        "first_name": "STEPHEN",
        "middle_name": "SALVATORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-083665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.