Individual provider Active NPI

Stephanie A Modert, DO MPH

  • Hospitalist Physician
  • Chicago, IL
National Provider Identifier
1609514249
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036175607 Issued in IL
Practice address
676 N Saint Clair St Ste 2330
Chicago, IL 60611-2915
Phone
(312) 926-6895
NPI assigned
May 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.175607 IL
Hospitalist Physician 208M00000X 036175607 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 2330
Chicago, IL 60611-2915

Mailing address

2411 Richview Rd
Mount Vernon, IL 62864-2740

Other practice location 1

251 E Huron St Ste 16-738
Chicago, IL 60611-3055
Phone (312) 926-5924

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250819003503 IL Practitioner - Hospitalist 6507244191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

251 E Huron St
Chicago, IL 60611-2908
Phone (312) 926-5924

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.175607ILMDInternal Medicine Physician
036175607ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2025 Accepting new patients
Central Dupage Physician Group Internal Medicine PastSince Jun 29, 2025 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

676 N Saint Clair St
Ste 2330
Chicago, IL 60611
Phone (312) 503-4494

251 E Huron St
Ste 16738
Chicago, IL 60611
Phone (312) 926-5924

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1609514249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 RICHVIEW RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 2330",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112915",
            "telephone_number": "312-926-6895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 E Huron St Ste 16-738",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606113055",
            "country_code": "US",
            "telephone_number": "312-926-5924",
            "fax_number": "312-926-6134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODERT",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "DO MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.175607",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036175607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.