Individual provider Active NPI

Stephanie Elizabeth Place, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1336460807
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036131979 Issued in IL
Practice address
1431 N Western Ave
Suite 406
Chicago, IL 60622-1797
Phone
(312) 633-5841
Fax
(312) 491-5020
NPI assigned
Jun 18, 2010
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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 036131979 IL Primary

Addresses

Primary practice location

1431 N Western Ave
Suite 406
Chicago, IL 60622-1797

Mailing address

1431 N Western Ave
Suite 401
Chicago, IL 60622-1797

Other identifiers 1

IdentifierTypeStateIssuer
036131979MedicaidIL

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
I20131010000522 IL Practitioner - Family Practice 0547494338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2010
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036131979ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Illinois Medical Group LLC Family Medicine CurrentSince Jun 13, 2025 Accepting new patients
Primecare Community Health, Inc. Family Medicine Current Accepting new patients
Primecare Community Health, Inc. Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
Primecare Community Health, Inc. Family Medicine Current Accepting new patients
Primecare Community Health Inc CurrentSince Jul 1, 2014 Accepting new patients
Presence Healthcare Services Family Medicine Current Accepting new patients
Primecare Community Health Inc. Past Accepting new patients
Primecare Community Health Inc Past Accepting new patients

Locations

1801 W Olympic Blvd
#2636
Pasadena, CA 91199

1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756

100 Provena Way
Ste 103
Bourbonnais, IL 60914
Phone (815) 937-8780

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

1431 N Western Ave
Ste 209
Chicago, IL 60622
Phone (312) 491-5435

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

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

62311 Collection Ctr Dr
Chicago, IL 60693

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

201 N Hammes Ave
Joliet, IL 60435
Phone (224) 273-6350

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1336460807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE",
            "address_2": "SUITE 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE",
            "address_2": "SUITE 406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221797",
            "telephone_number": "312-633-5841",
            "fax_number": "312-491-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLACE",
        "first_name": "STEPHANIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036131979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036131979",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.