Individual provider Active NPI

Stephanie Conn

  • Advanced Practice Midwife
  • Park Ridge, IL
National Provider Identifier
1306489950
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209.015652 Issued in IL
Practice address
1875 Dempster St Ste 245
Park Ridge, IL 60068-1126
Phone
(510) 585-7546
NPI assigned
Oct 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.397734 IL
Registered Nurse 163W00000X RN9S089711 CA
Advanced Practice Midwife 367A00000X 235837 CA
Advanced Practice Midwife 367A00000X 209.015652 IL Primary

Addresses

Primary practice location

1875 Dempster St Ste 245
Park Ridge, IL 60068-1126

Mailing address

1875 Dempster St Ste 245
Park Ridge, IL 60068-1126
Phone (510) 585-7546

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241217003195 IL Practitioner - Certified Nurse Midwife (CNM) 3678000544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Center for Women'S Healthcare, LTDGroup PAC ID 7012818354, 93 clinicians

Practice addresses (Care Compare)

1875 Dempster St
Suite 245
Park Ridge, IL 60068-1126
Phone (847) 692-9234

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN9S089711CAMDRegistered Nurse
041.397734ILMDRegistered Nurse
235837CAMDAdvanced Practice Midwife
209.015652ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Center for Women'S Health Care, LTD. CurrentSince Dec 12, 2024 Accepting new patients
Obstetrics, Gynecology & Infertility,S.C. Past Accepting new patients

Locations

2801 Lakeside Dr
Ste 209
Bannockburn, IL 60015
Phone (847) 562-1410

21660 W Field Pkwy
Fl 3
Deer Park, IL 60010
Phone (847) 692-9234

1875 Dempster St
Ste 245
Park Ridge, IL 60068
Phone (847) 692-9234

2604 Dempster St
Park Ridge, IL 60068
Phone (847) 219-9600

350 S Northwest Hwy
Ste 112
Park Ridge, IL 60068
Phone (847) 825-8108

2604 W Dempster St
Ste 410
Park Ridge, IL 60068
Phone (847) 692-9234

18931 W Washington St
Ste 100
Third Lake, IL 60030
Phone (847) 548-2200

Interoperability endpoints

  • Direct secure messaging: stephanie.conn.1@21117.direct.athenahealth.com

Organizations & group practices 2

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 3

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": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1306489950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST STE 245",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681126",
            "telephone_number": "510-585-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST STE 245",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681126",
            "telephone_number": "510-585-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-25",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.397734",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN9S089711",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "235837",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209.015652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.