Stuart A Issleib, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036074032 Issued in IL

Practice address

5201 Willow Springs Rd Ste 450
La Grange Highlands, IL 60525-6545

Phone

(630) 336-7870

Fax

(312) 328-7986

NPI assigned

Sep 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Stuart Issleib

  • Gastroenterology Physician
  • Chicago, IL
  • NPI 1912006529
  NPD (past) Authorized official

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1497740393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W NORTH ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213044",
            "telephone_number": "630-336-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD STE 450",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256545",
            "telephone_number": "630-336-7870",
            "fax_number": "312-328-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISSLEIB",
        "first_name": "STUART",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036074032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036074032",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110033745",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100009999",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "31603503",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE HMO",
            "identifier": "238276",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mustafa Hakim, CSA
• Shelley J. Halper, M.D.
• Nasreen Hamidani, M.D.
• Hillari Hanley, APRN-BC
• Carli Immordino, NURSE
• Courtney Jarva
• Robert Casper Johnson
• Kenneth Kessler, PH.D., MSCP
• Kleinmeyer Physical Therapy and Rehab Specialists
• Gary L Koehn, MD, PHD

• Gastroenterology Physician in La Grange Highlands, IL
• Providers in La Grange Highlands, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.