Stephen Tulley, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125.076412 Issued in IL

Practice address

350 N Wall St
Kankakee, IL 60901-2991

Phone

(815) 933-1671

NPI assigned

Jun 15, 2020

Last updated

Jun 15, 2020By the provider in NPPES

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

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

Specialty

Internal Medicine

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associates of Integrated Medicine LTDGroup PAC ID 3779876636, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uplifted Care Hospice, Bourbonnais, IL, CCN 141556
• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
• Miller Health Care Center Nursing home, Kankakee, IL, CCN 145843

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Associates of Integrated Medicine LTD.

  • Internal Medicine Physician
  • Kankakee, IL
  • NPI 1427407345
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospice of Kankakee Valley, Inc.

  • Community Based Hospice Care Agency
  • Bourbonnais, IL
  • NPI 1811935240
  Care Compare affiliation
• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation
• Riverside Senior Living Center

  dba Miller Health Care Center

  • Skilled Nursing Facility
  • Kankakee, IL
  • NPI 1174603377

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1629693726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012991",
            "telephone_number": "815-933-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012991",
            "telephone_number": "815-933-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLEY",
        "first_name": "STEPHEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.076412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruju Vivek Trivedi
• David Leneil Troupe, PHARMD
• Eunice Troupe, MS, RDN, LDN
• Eleni Tselos
• Malaya Abrigo Tuazon, M.D.
• Michael Ubaghara
• Ngozi V Ubaghara, APRN
• Israr Ul Haq, M.D.
• United Developmental Services
• Urological Surgeons of Illinois, LTD

• Internal Medicine Physician in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.