Organization Active NPI

George L Stankevych MD PC

  • Obstetrics & Gynecology Physician
  • McHenry, IL
National Provider Identifier
1376626952
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
GEORGE L STANKEVYCH MD PC
Practice address
4119 W Shamrock LN
Suite 200
McHenry, IL 60050-8289
Phone
(815) 344-1611
Fax
(815) 344-1614
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Authorized official

Name
George Lane Stankevych, M.D.NPI 1053312934
Title
President
Phone
(815) 344-1611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

4119 W Shamrock LN
Suite 200
McHenry, IL 60050-8289

Mailing address

4119 W Shamrock LN
Suite 200
McHenry, IL 60050-8289
Phone (815) 344-1611

Other identifiers 1

IdentifierTypeStateIssuer
5600259OtherILBCBS

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gstankevych288373@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326000027 IL Part B Supplier - Clinic/Group Practice 9931091840 Receives reassigned benefits from 3 practitioners
Practice locations: McHenry, IL

National Provider Directory

National Provider Directory

Locations

4119 W Shamrock Ln
Ste 200
McHenry, IL 60050
Phone (815) 344-1611

4309 W Medical Center Dr
Ste B300
McHenry, IL 60050
Phone (815) 344-1611

Interoperability endpoints

  • Direct secure messaging: gstankevych288373@direct.myadvocateaurora.org

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1376626952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 W SHAMROCK LN",
            "address_2": "SUITE 200",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508289",
            "telephone_number": "815-344-1611",
            "fax_number": "815-344-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 W SHAMROCK LN",
            "address_2": "SUITE 200",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508289",
            "telephone_number": "815-344-1611",
            "fax_number": "815-344-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE L STANKEVYCH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "STANKEVYCH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-344-1611",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5600259",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gstankevych288373@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4119 W Shamrock Ln",
            "address_2": "SUITE 200",
            "city": "McHenry",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600508289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4119 W Shamrock Ln",
            "address_2": "SUITE 200",
            "city": "McHenry",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600508289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.